宫腹腔镜联合炔雌醇环丙孕酮治疗剖宫产术后子宫切口憩室的临床疗效

Clinical effect of laparoscopy combined with eparylestradiol cyproterone in treatment of post cesarean scar diverticulum

目的探讨宫腹腔镜联合炔雌醇环丙孕酮治疗剖宫产术后子宫切口憩室(PCSD)的临床疗效。方法选取2016年7月至2020年6月于合肥市第二人民医院诊疗的102例PCSD患者为研究对象,按照随机数字法,分为对照组(仅临床上定期随访)、宫腹腔镜组(仅接受宫腹腔镜联合手术)和综合治疗组(接受宫腹腔镜联合手术后,辅助炔雌醇环丙孕酮药物治疗),每组34例。评估3组患者第6个月经周期后的月经改善总有效率及PCSD修复率情况。结果宫腹腔镜组、综合治疗组患者月经改善总有效率分别为82.35%和97.06%,均高于对照组(17.65%),且综合治疗组高于宫腹腔镜组,差异均有统计学意义(P<0.05)。宫腹腔镜组、综合治疗组患者PCSD修复率分别为85.30%和88.23%,均高于对照组(11.76%),差异均有统计学意义(P<0.05)。结论宫腹腔镜手术治疗PCSD时可以有效切除憩室,缩短月经经期,且以炔雌醇环丙孕酮辅助治疗后效果更佳,值得临床应用。

Objective To investigate the clinical effect of laparoscopy combined with eparylestradiol cyproterone in the treatment of post cesarean scar diverticulum.Methods A total of 102 patients in our hospital diagnosis from July 2016 to June 2020 with uterine incision diverticulum after cesarean section were selected as the research object.According to whether surgery and/or drug therapy was performed,they were divided into control group,hysteroscopy group and combined treatment group,with 34 cases in each group.The total effective rate of menstrual improvement after the sixth menstrual cycle and PCSD repair rate in three groups were assessed.Results The effective rate of menstrual improvement in the laparoscopic group and the comprehensive treatment group was 82.35%and 97.06%respectively,which was both higher than that in the control group(17.65%),and it was higher in the comprehensive treatment group than in the laparoscopic group(P<0.05).PCSD repair rate in the laparoscopic group and comprehensive treatment group was 85.30%and 88.23%respectively,which was both higher than that in the control group(11.76%)(P<0.05).Conclusions Hysteroscopic laparoscopic surgery can remove the diverticulum after cesarean section and shorten the menstrual period,and the effect of adjuvant treatment with ethinyl estradiol and cyproterone is better.