Objective. To compare the effects of hysteroscopic cold broad sword play combined with estrogen and progestin sequential therapy and drospirenone and ethinylestradiol tablets in patients with severe intrauterine adhesion. Methods. One hundred and eight patients with severe IUA admitted to our hospital from May 2019 to October 2021 were selected for the study. Patients were divided according to their treatment regimen into group A (n = 54) treated with hysteroscopic cold broad sword play + drospirenone and ethinylestradiol tablets and group B (n = 54) treated with hysteroscopic cold broad sword play + estrogen and progestin sequential therapy. The two groups were compared in terms of perioperative indicators, recovery of uterine cavity status, inflammatory factor (C-reactive protein (CRP), interleukin 6 (IL-6), and interleukin 8 (IL-8)] levels), World Health Organization Quality of Life Brief Scale (WHOQOL-BREF) score, and clinical outcome at 3 months postoperatively. Result. After surgery, the duration of abdominal pain and vaginal bleeding was shorter in group A than in group B ( P < 0.05 ). After surgery, the time of menstruation return was shorter in group A than in group B, and the menstrual flow score was higher than in group B ( P < 0.05 ). At 3 months after the surgery, the uterine blood flow index, endometrial thickness, and uterine cavity volume were higher in group A than in group B, and the number of uterine readhesion was lower than in group B ( P < 0.05 ). 3 months after the surgery, the CRP, IL-6, and IL-8 levels decreased in both groups and were lower in group A than in group B ( P < 0.05 ). At 3 months after the surgery, the WHOQOL-BREF scores for each indicator were higher in both groups than before surgery and were higher in group A than in group B ( P < 0.05 ). At 3 months after the surgery, the overall valid rate of group A was 94.44% better than that of group B at 79.63% ( P < 0.05 ). Conclusion. The combination of hysteroscopic cold broad sword play with drospirenone and ethinylestradiol tablets has been shown to be more effective than combined estrogen and progestin sequential therapy in the treatment of patients with severe IUA, which significantly improves the post-operative menstrual status and uterine cavity morphology, significantly reduces the level of inflammatory factors in the patient’s body, and significantly improves the quality of life, which is of value.

ObjectiveTo explore the efficacy, safety, and prognostic factors of intensity modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) combined with intracavitary posterior radiotherapy for medium-term and advanced cervical cancer.MethodsRetrospectively analyze the clinical data of 104 patients with medium-term and advanced cervical cancer who were treated in the radiotherapy department of our hospital from September 2015 to March 2017. According to the different radiotherapy techniques, they were divided into the IMRT combined with intracavitary posterior radiotherapy group (n = 52) and the 3D-CRT combined with intracavitary posterior radiotherapy group (n = 52). Observe and compare the short-term efficacy, occurrence of adverse reactions and overall survival rate of the two groups. The clinicopathological characteristics of the survival group and the death group were compared, and univariate analysis and multiple logistic regression models were used to analyze the relationship between the clinicopathological characteristics and the patient’s prognosis.ResultsThe total effective rate of IMRT combined with intracavitary posterior radiotherapy group was 96.15%, which was higher than that of 3D-CRT combined with intracavitary posterior radiotherapy group (88.46%), but the difference was not statistically significant (p &gt; 0.05). The incidence of digestive system injury, thrombocytopenia, and radiation proctitis in the IMRT combined intracavitary posterior radiotherapy group was lower than that of the 3D-CRT combined intracavitary posterior radiotherapy group, and the differences were statistically significant (p &lt; 0.05). The prognosis and survival of the two groups of patients were similar, and the difference was not statistically significant (p &gt; 0.05). Pathological classification, clinical stage, and lymph node metastasis are independent influencing factors of 3-year prognosis in patients with medium-term and advanced cervical cancer (p &lt; 0.05).ConclusionIMRT combined with intracavitary posterior radiotherapy is equivalent to 3D-CRT combined with intracavitary posterior radiotherapy, but it can reduce the incidence of adverse reactions in patients with medium-term and advanced cervical cancer, and has higher safety. Pathological typing, clinical staging, Lymph node metastasis were independent factor affecting the prognosis of patients. In clinical treatment, IMRT combined with intracavitary posterior radiotherapy is more recommended as a treatment plan for patients with medium-term and advanced cervical cancer.