剖宫产术后子宫切口憩室的微创手术方式探讨

Discussion on minimally invasive surgical methods of uterine incision diverticulum after cesarean section

目的：寻找适合剖宫产术后子宫切口憩室的微创手术治疗方式。方法：分析2011年1月~2013年1月55例因剖宫产憩室接受微创手术治疗的患者,研究组行腹腔镜辅助下经阴道剖宫产切口憩室修补术,对照组行宫腔镜下治疗剖宫产切口憩室,比较两组患者手术效果及安全性。结果：研究组与对照组患者的手术有效率分别为96.55%、69.23%,术后月经平均缩短分别为6.46天、4.49天,术后并发症发生率分别为3.45%、34.62%,研究组较对照组手术有效率高,术后月经缩短天数多,并发症发生率低（P〈0.05）;研究组与对照组患者的平均手术费用分别为8 139.83元、6 236.13元,手术时间分别为48.78 min、78.23 min,对照组较研究组费用低,手术时间短（P〈0.05）。结论：虽然宫腔镜下治疗剖宫产切口憩室快速、价低,但手术效果较差,风险高;腹腔镜辅助下经阴道修补剖宫产切口憩室治疗效果好,安全性高,是一种适合剖宫产切口憩室治疗的微创手术方式。

Objective： To find suitable methods for minimally invasive surgery of uterine incision diverticulum after cesarean sec- tion. Methods ： Fifty - five patients undergoing minimally invasive surgery of uterine incision diverticulum after cesarean section from Janu- ary 2011 to January 2013 were analyzed, the patients in study group were treated with laparoscopic - assisted transvaginal cesarean section incision diverticulum repair, while the patients in control group were treated with cesarean section incision diverticulum repair under hysteroscope ; the surgical results and safeties in the two groups were compared. Results ： The effective rates of operation in study group and control group were 96. 55% and 69. 23% , respectively; the average menstrual times after operation in study group and control group were 6. 46 days and 4.49 days, respectively; the incidence rates of postoperative complications in study group and control group were 3.45% and 34. 62%, respectively ; there were statistically significant differences in the effective rate of operation, the average menstrual time and the incidence rate of postoperative complications between study group and control group （ P 〈 0. 05 ） . The average operation fees in study group and control group were 8 139. 83 Yuan and 6 236. 13 Yuan, respectively; the average operation times were 48.78 minutes and 78.23 minutes, respec- tively, there were statistically significant differences between study group and control group （ P 〈 0. 05 ） . Conclusion： Cesarean section incision diverticulum repair under hysteroscope is fast and the price is low, but the efficacy is poor and the risk is high ; the efficacy of laparoscopic - assisted transvaginal cesarean section incision diverticulum repair is good, and the safety is high, which is a minimally invasive surgical method for treatment of uterine incision diverticulum after cesarean section.