脉冲磁疗、盆底肌肉高强度磁刺激和宫内血浆疗法对恢复宫内干预后子宫内膜接受能力的疗效:随机试验

M. Guschina, E. Zhumanova, N. B. Korchazhkina, D. Kolgaeva
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The patients were divided into three equal groups: group 1 — 40 patients who received combined pulsed magnetic therapy and intrauterine plasma therapy of the endometrium; group 2 — 40 patients who underwent high-intensity magnetic stimulation of the pelvic floor muscles and intrauterine plasma therapy of the endometrium; group 3 — 40 patients who underwent pulsed magnetic therapy. Anamnesis data, as well as clinical, laboratory, and instrumental data of the patients were analyzed, an ultrasound assessment of endometrial thickness and blood flow velocity in the uterine arteries was performed, and the pregnancy rate was assessed 1, 2, and 3 months after treatment. Results. The probability of pregnancy in group 1 was significantly higher than in group 3 (p = 0.014), but it did not reach statistically significant differences from the first group. 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引用次数: 0

摘要

对盆腔器官的手术干预会导致子宫内膜基底层受损,从而影响胚胎着床。恢复子宫内膜的接受能力有助于提高生育能力。研究目的评估育龄妇女宫内干预后使用非药物方法恢复子宫内膜受孕能力的有效性。材料和方法。这项前瞻性随机研究纳入了 120 名年龄在 18-45 岁之间、接受过宫内手术并计划怀孕的患者。这些患者被分为三个相同的小组:第1组--40名患者接受脉冲磁疗和子宫内膜宫内等离子治疗;第2组--40名患者接受盆底肌肉高强度磁刺激和子宫内膜宫内等离子治疗;第3组--40名患者接受脉冲磁疗。对患者的病史、临床、实验室和仪器数据进行了分析,对子宫内膜厚度和子宫动脉血流速度进行了超声波评估,并在治疗后 1、2 和 3 个月对妊娠率进行了评估。结果显示第 1 组的妊娠概率明显高于第 3 组(P = 0.014),但与第 1 组相比差异无统计学意义。第二组的治疗方法最有效地提高了怀孕几率(70%)(风险比 2.37(95% 置信区间 1.10-5.11),p = 0.027)。服用维生素可使怀孕几率增加 72%,无慢性疾病可使怀孕几率增加 81%,年龄较小可使怀孕几率增加 49%,体重指数正常可使怀孕几率增加 48%。根据所获得的数据,预测治疗效果好和怀孕几率高的因素如下:子宫内膜厚度在 1 个月后超过 7.5 毫米,2 个月后超过 9.5 毫米,3 个月后超过 10.5 毫米;血流速度在 2 个月后超过 11.5 毫米/秒,3 个月后超过 13.5 毫米。结论宫腔内干预术后恢复子宫内膜受孕率最高的方法是使用康复综合疗法,包括联合使用高强度磁刺激盆底肌肉和宫腔内血浆疗法。在治疗过程中,子宫内膜的厚度和子宫动脉的血流速度可预测治疗和怀孕的良好结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of pulsed magnetic therapy, high-intensity magnetic stimulation of the pelvic floor muscles and intrauterine plasma therapy to restore endometrial receptivity after intrauterine interventions: a randomized trial
Surgical interventions on the pelvic organs lead to damage to the basal layer of the endometrium, which disrupts embryo implantation. Restoring endometrial receptivity helps improve fertility. Purpose of the study. Evaluation of the effectiveness of non-drug methods for restoring endometrial receptivity after intrauterine interventions in women of reproductive age. Material and methods. The prospective randomized study included 120 patients aged 18–45 years who had undergone intrauterine surgery and were planning pregnancy. The patients were divided into three equal groups: group 1 — 40 patients who received combined pulsed magnetic therapy and intrauterine plasma therapy of the endometrium; group 2 — 40 patients who underwent high-intensity magnetic stimulation of the pelvic floor muscles and intrauterine plasma therapy of the endometrium; group 3 — 40 patients who underwent pulsed magnetic therapy. Anamnesis data, as well as clinical, laboratory, and instrumental data of the patients were analyzed, an ultrasound assessment of endometrial thickness and blood flow velocity in the uterine arteries was performed, and the pregnancy rate was assessed 1, 2, and 3 months after treatment. Results. The probability of pregnancy in group 1 was significantly higher than in group 3 (p = 0.014), but it did not reach statistically significant differences from the first group. The treatment method in group 2 increased the likelihood of pregnancy most effectively (by 70 %) (risk ratio 2.37 (95 % confidence interval 1.10–5.11), p = 0.027). Taking vitamins increased the chance of getting pregnant by 72 %, absence of chronic diseases — by 81 %, younger age — by 49 %, and normal body mass index — by 48 %. Based on the data obtained, the predictors of a favorable treatment outcome and a high probability of pregnancy are as follows: endometrial thickness more than 7.5 mm after 1 month, more than 9.5 mm after 2 months, more than 10.5 mm after 3 months; blood flow velocity more than 11.5 mm/s after 2 months and more than 13.5 mm after 3 months. Conclusion. The highest probability of restoration of endometrial receptivity after intrauterine interventions and pregnancy occurs when using a rehabilitation complex, including the combined use of high-intensity magnetic stimulation of the pelvic floor muscles and intrauterine plasma therapy. Predictors of a favorable outcome of treatment and pregnancy are the thickness of the endometrium and the blood flow velocity in the uterine arteries during the course of therapy.
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