两种不同手术方式处理剖宫产疤痕憩室的研究

Analysis of Two Different Surgical Methods for Cesarean Scar Diverticulum

目的:探讨两种不同手术方式处理剖宫产疤痕憩室的疗效。方法:2013年3月~2015年3月收治60例有手术指征的剖宫产疤痕憩室患者,阴式手术组采用经阴道子宫疤痕憩室切除+子宫修补术,宫腹腔镜组采用腹腔镜联合宫腹镜下子宫疤痕憩室切除+子宫修补术,并比较两种术式术后月经的改变及疤痕憩室修复状况。结果:对所有患者术后6个月、12个月的月经量、持续时间及憩室是否消失情况进行比较,在手术后6个月及12个月,阴式手术组患者的月经量的改变及子宫疤痕憩室的愈合显著高于宫腔镜组,比较差异均具有显著统计学意义(P<0.05)。结论:疤痕憩室修补术是CSD的有效、安全术式,适用于有症状、欲改善生活质量的患者,阴式手术疗效优于宫腹腔镜手术。

Objective：To compare the effect of two different operations for cesarean scar diverticulum.Methods：60cases of patients with operation indications of cesarean scar diverticulum were selected and randomly divided into two groups,with 30 cases in each group.The vaginal operation group was given transvaginal uterine scar diverticulum resection combined uterus repair,and the hysteroscopy combined laparoscopy group was treated with ulterine scar diverticulum resection under hysteroscopy combined laparoscopy and uterus repair,then compared the menstrual changes and repair status of scar diverticulum after treatment of two groups.Results：The menstrual blood volume,time of duration,and the situation of diverticulum after 6and 12 months of all patients were compared.The postoperative menstrual changes and repair status of scar diverticulum after a follow-up of 6and 12 months of vaginal operation group were significantly higher than those of hysteroscopy combined laparoscopy group（P〈 0.05）.Conclusion：Repair of scar diverticulum for CSD is effective and safe,which is especially suitable for symptomatic patients who want to improve the quality of life.The treatment effect of vaginal operation is better than hysteroscopy combined hysteroscope operation.