宫腹腔镜联合手术与阴式憩室修补术治疗剖宫产子宫切口瘢痕憩室的疗效观察

The Observation of curative effect in treatment of cesarean section uterine incision scar compartment

目的:探讨宫腹腔镜联合手术与阴式憩室修补术治疗剖宫产后子宫切口瘢痕憩室的临床疗效.方法:回顾性分析90例我院收治的剖宫产术后子宫切口瘢痕憩室患者,根据手术方案不同分为2组,采用宫腹腔镜联合手术治疗的42例患者为腔镜组,采用阴式憩室修补术治疗的48例患者为阴式组,比较两组患者围手术期情况、并发症发生率和术后3个月的经期恢复情况、子宫憩室修复情况.结果:腔镜组手术时间显著长于、术后阴道出血时间和住院时间显著短于阴式组;阴式组术中出血量显著少于、治疗费用显著低于腔镜组;腔镜组并发症发生率显著低于阴式组.两组患者在排气时间、经期恢复情况和子宫憩室修复情况上差异无统计学意义.结论:宫腹腔镜联合手术与阴式憩室修补术均能有效治疗剖宫产术后子宫切口瘢痕憩室,各有优势,在临床上可根据患者的实际病情制定合适的治疗方案.

Objective To investigate the clinical efficacy of laparoscopic combined surgery and vaginal diverticulum repair in the treatment of uterine incision scar compartment after cesarean section. Methods 90 patients with uterine incision scar sacral cavity after cesarean section in our hospital was divided into 2 groups according to the surgical plan.42 patients who underwent laparoscopic surgery were put into the laparoscopic group, 48 patients treated with diverticulum repair were in the vaginal group. The perioperative status, complication rate, menstrual recovery at 3 months postoperatively, and uterine diverticulum repair were compared between the two groups. Results The operative time of the laparoscopic group was significantly longer than that of the vaginal group, time of postoperative vaginal bleeding and hospitalization time was significantly shorter than those of the vaginal group. The amount of bleeding in the vaginal group was significantly less than that in the vaginal group, the cost of treatment in the vaginal group was significantly lower than that in the laparoscopic group;the incidence of complications in the laparoscopic group was significantly lower than that in the vaginal group . There was no significant difference in the exhaust time, menstrual recovery and uterine diverticulum repair between the two groups. Conclusion Both laparoscopic laparoscopic surgery and vaginal diverticulum repair can effectively treat the uterine incision scar compartment after cesarean section. Each way has its own advantages. It can be clinically based on the actual condition of the patient to develop a suitable treatment plan.