宫腹腔镜下不同手术方式对剖宫产术后子宫切口憩室的疗效

Effect of Different Surgical Methods Under Hysteroscopic Laparoscopy in Uterine Incision Diverticulum After Cesarean Section

目的探讨宫腹腔镜下不同手术方式对剖宫产术后子宫切口憩室患者的临床疗效。方法收集叶县妇幼保健院收治的88例剖宫产术后发生子宫切口憩室患者的临床资料。按照手术方案分为单纯修补组和联合组,各44例。单纯修补组接受宫腹腔镜联合修补手术,联合组接受宫腹腔镜下叠瓦式缝合术联合圆韧带缩短术。比较两组手术效果、手术情况、术后恢复情况、并发症发生率、复发率及手术前后憩室深度、宽度。结果联合组手术治疗总有效率高于单纯修补组(P<0.05);术后6个月,两组憩室深度、宽度较术前减小,联合组小于单纯修补组(P<0.05);联合组术后1 a复发率低于单纯修补组(P<0.05)。结论宫腹腔镜下叠瓦式缝合术联合圆韧带缩短术治疗剖宫产术后子宫切口憩室患者,可降低疾病复发率,具有较高的安全性,值得在临床推广使用。

Objective To explore the clinical efficacy of different surgical methods under hysteroscopic laparoscopy in the treatment of patients with uterine incision diverticulum after cesarean section.Methods The clinical data of 88 patients with uterine incision diverticulum after cesarean section in Ye County Maternal and Child Health Hospital were collected,and they were divided into simple repair group and combined group according to operation plans,with 44 cases in each group.The simple repair group accepted hysteroscopic combined repair operation,and the combined group accepted hysteroscopic laparoscopy suturing combined with teres ligament shortening.The surgical treatment effect,surgical conditions,postoperative recovery,the incidence of complications and recurrence,diverticulum depth and width before and after surgery were compared between two groups.Results The total effective rate of surgical treatment in combined group was higher than that in simple repair group(P<0.05).After 6 months of operation,the depth and width of diverticulum in two groups were reduced,and the depth and width of diverticulum in combined group were smaller than those in simple repair group(P<0.05).After 1 year of operation,the recurrence rate in combined group was lower than that in simple repair group(P<0.05).Conclusion Hysteroscopic laparoscopy suturing combined with teres ligament shortening in the treatment of uterine incision diverticulum after cesarean section can reduce recurrence rate,and do not increase postoperative complications,which is worthy of wide application in clinical.