阴式剖宫产子宫瘢痕憩室病灶清除术的临床疗效

Clinical efficacy of vaginal cesarean section scar scaring diverticulum debridement

目的探究阴式剖宫产子宫瘢痕憩室病灶清除术的临床疗效.方法回顾性分析2017年2月至2018年2月份本院确诊的58例子宫瘢痕缺陷(PCSD)患者,采用随机数字表法分为阴式组与宫腹腔镜组,每组29例.宫腹腔镜组采用宫腹腔镜联合切除缝合子宫切口憩室术,阴式组采用阴式手术.分析两组患者术中与术后临床指标改善情况及住院费用等指标.结果宫腹腔镜组血人绒毛膜促性腺激素(β-HCG)转阴时间短,切口肌层厚度大,手术时间、经期平均缩短时间和住院费用与阴式组对比差异有统计学意义(P<0.05),而两组术中与术后出血量、追加甲氨碟呤(MTX)例数、出血量、肛门排气时间及住院时间对比差异无统计学意义;阴式组的经期恢复有效率(93.10%)、B超下憩室修复有效率(96.55%)及并发症发生率(3.45%)分别与宫腹腔镜组(86.20%、89.66%、13.80%)对比差异无统计学意义.结论微创的阴式PCSD切除术有助于患者经期、憩室快速恢复,围术期出血少,治疗费用低,术后并发症少,值得临床推广.

Objective To explore the clinical efficacy of vaginal cesarean section for the removal of uterine scar and diverticulum lesions. Methods A total of 58 patients with uterine scar defect (PCSD) diagnosed in our hospital from February 2017 to February 2018 were retrospectively analyzed. The patients were divided into Yin group and hysteroscopy group by random number table method, with 29 cases in each group. The uterine laparoscope group adopted combined hysteroscopy and suture uterine incision diverticulum, and the vaginal group adopted vaginal surgery. The improvement of intraoperative and postoperative clinical indicators and hospitalization costs were analyzed. Results Palace laparoscopic group blood human chorionic gonadotropin (beta HCG) turn time is short, muscular layer thickness of incision, operation time and average period shorten the time and cost of hospitalization and Yin type contrast group difference was statistically significant (P<0.05), and two groups of intraoperative and postoperative blood loss, additional armour ammonia disc poison (MTX), the number of cases, the bleeding, anal exhaust time and hospital stay there was no statistically significant difference compared with;There were no statistically significant differences in the menstrual recovery rate (93.10%), diverticulum repair rate (96.55%) and complication rate (3.45%) of the vaginal group and the hysteroscopy group (86.20%, 89.66%, 13.80%), respectively. Conclusion Minimally invasive vaginal PCSD resection is helpful for the rapid recovery of menstruation and diverticulum in patients, with less perioperative bleeding, low treatment cost and fewer postoperative complications, which is worthy of clinical promotion.