不同手术方式治疗剖宫产瘢痕憩室的疗效研究

Efficacy of different surgical methods based on cesarean scar diverticulum grading

目的 探讨不同手术方式治疗剖宫产瘢痕憩室(cesarean scar defect,CSD)的疗效。方法 选取2015年6月至2020年6月在温州市人民医院住院并行手术治疗的剖宫产瘢痕憩室患者共78例进行回顾性分析,按手术方式不同分为宫腔镜组(宫腔镜下子宫瘢痕憩室电切术,n=13)、阴式组(经阴道子宫瘢痕憩室修补手术,n=35)和宫腹腔镜组(宫腹腔镜联合子宫瘢痕憩室修补手术,n=30),对3组术中出血量、住院时间、住院费用、治疗效果等进行比较。结果 宫腔镜组的住院时间最短,术中出血量、住院费用均最少,差异有统计学意义(P<0.05)。3组的好转率、治愈率、有效率比较,差异无统计学意义(P>0.05)。结论 3种手术方式治疗CSD均具有良好的有效性,宫腔镜手术在术中出血量、住院时间以及住院费用等方面更具优势。

Objective To evaluate the efficacy of different surgical methods in the treatment of cesarean scar diverticulum(CSD).Methods A total of 78 patients diagnosed with cesarean scar diverticulum and treated with surgery in Wenzhou People’s Hospital from June 2015 to June 2020 were selected for retrospective analysis. According to different surgical methods, they were divided into the hysteroscopic group(hysteroscopic electrocutting of uterine scar diverticulum, n=13), the transvaginal group(transvaginal repair of uterine scar diverticulum, n=35), and the hysterolaparoscopic group(laparoscopic repair of uterine scar diverticulum, n=30), compared intraoperative bleeding, hospital days, hospital costs and therapeutic outcomes in the three groups.Results The intraoperative bleeding, hospitalization cost and hospital stay were the least in the hysteroscopic group, and the differences were statistically significant(P<0.05). There was no statistically significant difference between the improvement rate,cure rate, and efficiency rate of the three groups(P>0.05). Conclusion All the three surgical methods have good effectiveness in the treatment of CSD. Hysteroscopic surgery has more advantages in intraoperative blood loss, hospitalization time and hospitalization cost.