剖宫产术后子宫切口憩室治疗方案探讨

Study on treatment protocols for uterine incision diverticulum after cesarean section

目的:探讨剖宫产术后子宫切口憩室的治疗方案。方法:选取60例剖宫产术后子宫切口憩室患者作为研究对象,依据随机数字表法将其分为对照组和观察组各30例,对照组行阴式手术治疗,观察组行宫腹腔镜联合手术治疗,比较两组手术指标(手术时间、术后首次排气时间、手术出血量、住院时间)、手术前后切口憩室深度、经期及并发症发生情况。结果:观察组手术时间、术后首次排气时间及住院时间均明显短于对照组,手术出血量明显少于对照组,差异均有统计学意义(P<0.05);术后观察组切口憩室深度明显小于对照组,经期明显短于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为6.67%(2/30),明显低于对照组的26.67%(8/30),差异有统计学意义(P<0.05)。结论:与阴式手术相比,宫腹腔镜联合手术治疗剖宫产术后子宫切口憩室的效果更好,可有效改善憩室深度及经期,缩短住院时间,且术后并发症更少。

Objective: To study treatment protocols of uterine incision diverticulum after cesarean section. Methods: 60 patients with uterine incision diverticulum after cesarean section were selected as the study subjects. According to the random number table method, they were divided into control group and observation group, 30 cases in each. The control group underwent vaginal surgery, while the observation group underwent hysteroscopy combined with laparoscopic surgery. The surgical indexes(surgery time, first exhaust time, surgical bleeding volume,hospitalization time), depth of incision diverticulum, menstrual period and complications were compared between the two groups. Results: The operation time, first exhaust time and hospitalization time of the observation group were less than those of the control group, the vaginal bleeding volume was significantly less than that of the control group, and the differences were statistically significant(P<0.05). The depth of incision diverticulum in the observation group was significantly lower than that in the control group, the menstrual period was significantly shorter than that in the control group, and differences were statistically significant(P<0.05). The complication rate in the observation group was 6.67%(2/30), which was significantly lower than that in the control group of 26.67%(8/30), and the difference was statistically significant(P<0.05). Conclusions: Compared with the vaginal surgery, the hysteroscopy combined with laparoscopic surgery for uterine incision diverticulum after cesarean section is superior. It can effectively improve the diverticulum depth and menstrual period and shorten the hospitalization time with fewer postoperative complications.