宫、腹腔镜联合手术和阴式手术治疗剖宫产术后子宫切口憩室的效果对比

Effects comparison of hysteroscopy combined with laparoscopic surgery and vaginal surgery on uterine incision diverticulum after cesarean section

目的探讨宫、腹腔镜联合手术和阴式手术治疗剖宫产术后子宫切口憩室的效果。方法将2014年1月~2015年12月在我院接受治疗的60例剖宫产术后子宫切口憩室患者按照随机数字表法平均分为两组,30例患者行阴式手术治疗(对照组),30例行宫、腹腔镜联合手术治疗(研究组)。对比两组患者手术情况、手术疗效及并发症情况。结果研究组患者手术优良率显著优于对照组,差异有统计学意义(P<0.05)。研究组患者术后阴道出血时间及术后住院时间显著少于对照组,但术中出血量、手术时间、肛门排气时间及治疗费用显著高于对照组(P<0.05)。研究组患者并发症发生率显著低于对照组(P<0.05)。研究组患者术后1年月经恢复正常患者例数显著多于对照组,且小憩室患者例数显著少于对照组(P<0.05)。结论阴式手术治疗患者手术时间短,术中出血量少,对患者损伤小,但临床疗效不如宫、腹腔镜联合手术,且并发症发生率高于宫、腹腔镜联合手术。

Objective To study the effect of hysteroscopy combined with laparoscopic surgery and vaginal surgeryon uterine incision diverticulum after cesarean section.Methods60cases of uterine incision diverticulum aftercesarean section cured in our hospital from January2014to December2015were randomly divided into two groupswith30cases in each.Patiens in control group were treated with transvaginal surgical treatment.Patients in studygroup were treated with hysteroscopy combined with laparoscopic surgery.The operation condition,operation effectand complications of the two groups were compared.Results The excellent rate of operation in the study group wassignificantly better than that in the control group(P<0.05).The time of vaginal bleeding and postoperative hospitalstay in the study group were significantly less than those in the control group,but the amount of bleeding,operationtime,anal exhaust time and treatment costs were significantly higher than those in the control group(P<0.05).Theincidence of complications in the study group was significantly lower than that in the control group(P<0.05).Thenumber of patients with normal menstruation after1years in the study group was significantly higher than that in thecontrol group,and the number of patients with small diverticulum was significantly less than that of the control group(P<0.05).Conclusion The operation time of the vaginal operation is shorter,the amount of bleeding is less,andthe injury is less,but the clinical efficacy is less than the combined operation of hysteroscopy and laparoscopy,and theincidence of complications is higher than that of hysteroscopy combined with laparoscopic surgery.