瘢痕子宫剖宫产术中同时行剖宫产术后子宫瘢痕缺损修补的临床效果

Effect on the simultaneous repair of previous cesarean scar defect during scar uterine cesarean section

目的分析瘢痕子宫剖宫产术中同时行剖宫产术后子宫瘢痕缺损(PCSD)修补的临床效果。方法选取汕尾市第二人民医院2020年1月至2021年1月收治的瘢痕子宫需行剖宫产产妇120例为研究对象,采用单盲法随机分为两组,每组各60例。研究组采取PCSD修补法,对照组采取双层连续缝合法,比较两组患者治疗效果。结果研究组术后肛门排气时间、血性恶露持续时间短于对照组,产后出血率及血红蛋白下降值低于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率为96.67%,高于对照组的85.00%,差异有统计学意义(P<0.05)。研究组慢性盆腔痛、异常子宫出血、剖宫产子宫切口愈合不良发生率、PCSD形成率、瘢痕憩室容积低于对照组,瘢痕憩室残余子宫肌层厚度高于对照组,差异有统计学意义(P<0.05)。结论瘢痕子宫需行剖宫产产妇实行PCSD修补,能够降低患者术后出血量,改善血性恶露情况,降低PCSD形成率,实践价值较高。

Objective Clinical effect on the simultaneous repair of previous cesarean scar defect(PCSD)during scar uterine cesarean section.Methods A total of 120 puerperants with scarred uterus requiring cesarean section who were admitted to the Shanwei Second People’s Hospital from January 2020 to January 2021 were selected as the research subjects and randomly divided into two groups by single-blind method,with 60 cases in each group.The study group adopted the PCSD repair method.The control group was treated with double-layer continuous suture method.The therapeutic effects of the two groups were compared.Results The postoperative anal exhaust time and duration of lochia rubra were shorter in the study group than those in the control group,and the postpartum bleeding rate and hemoglobin drop value were lower than that in the control group,with statistically significant differences(P<0.05).The effective rate of 96.67%in the study group was higher than 85.00%in the control group,with statistically significant difference(P<0.05).The incidence of chronic pelvic pain,abnormal uterine bleeding,poor healing of cesarean section uterine incision,PCSD formation rate,and scar diverticulum volume in the study group were lower than those in the control group,residual myometrium thickness in the study group was higher than that in the control group,with statistically significant differences(P<0.05).Conclusion The PCSD repair for women who need cesarean section with scar uterus can reduce postoperative bleeding,improve lochia rubra and reduce the PCSD formation rate,which has high practical value.