Abstract: Objective: To observe the effects of aspirin combined with electrical stimulation of pelvic floor smooth muscle on the endometrium of the intrauterine adhesion(IUA) patients after hysteroscopic adhesiolysis, and to clarify its improvement effect on the neovascularization and blood circulation after operation of the IUA patients. Methods: Eighty patients with moderate or severe IUA, having fertility intention, were divided into control group, drug group, electrical stimulation group and combination group(n=20), and all the patients underwent hysteroscopic adhesidysis. The patients in control group were treated with estrogen progesterone sequential therapy,the patients in drug group were treated with estrogen progesterone sequential therapy plus aspirin, the patients in electrical stimulation group were treated with estrogen progesterone sequential therapy combined with pelvic floor smooth muscle stimulation,and the patients in combination group were treated with estrogen progesterone sequential therapy plus aspirin combined with pelvic floor smooth muscle stimulation. The efficacies of patients in various groups before and after treatment were compared, and the endometrium thickness (ET), pulsatility index (PI), resistance index (RI), pregnancy status,and the endometrium microvessel density (MVD) values of the IUA patients in various groups were observed;the expression levels of vascular endothelial growth factor (VEGF) mRNA and protein in endometrial tissue of the IUA patients in various groups were detected by RT-qPCR and Western blotting methods. Results: The total effective rate of patients in combination group was significantly higher than those in control group, drug group and electricalal stimulation group(P<0.05). Compared with before treatment, the ET of the IUA patients in drug group, electrical stimulation group and combination group after treatment were increased significantly (P<0.05), and PI and RI were decreased significantly (P<0.05);after treatment,the PI and RI of the IUA patients in combination group were significantly lower than those in control group, drug group and electrical stimulation group (P<0.05). Compared with before treatment, the endometrium MVD values of the IUA patients in electrical stimulation group and combination group after treatment were increased significantly (P<0.05); the endometrium MVD value of the IUA patients in combination group was significantly higher than those in control group, drug group and electrical stimulation group (P<0.05). Compared with before treatment, the expression levels of VEGF mRNA and protein in endometrial tissue of the IUA patients in control group, drug group, electrical stimulation group and combination group after treatment were significantly increased (P<0.05); after treatment, the expression levels of VEGF mRNA and protein of the IUA patients in combination group were significantly higher than those in control group, drug group and electricalal stimulation group (P<0.05). Conclusion: Aspirin combined with electrical stimulation pelvic floor smooth muscle can significantly improve the ET of the patients, and increase the uterine blood circulation after hysterocopic adhesiolysis.

Key words: uterine cavity adhesion, electrical stimulation of pelvic floor smooth muscle, microvascular density, vascular endothelial growth factor, aspirin