宫腹腔镜联合子宫瘢痕憩室整形折叠对接术在临床中的应用分析

Analysis of clinical application of hysteroscopy combined with laparoscopic uterine scar diverticulum plastic folding surgery

目的探讨宫腹腔镜联合下子宫瘢痕憩室整形折叠对接术在治疗剖宫产术后子宫瘢痕憩室肌层厚度<3 mm的临床应用价值,并分析评价该手术方式在治疗子宫瘢痕憩室肌层厚度<3 mm的疗效。方法回顾性分析河南省人民医院2018年11月至2019年6月采用此手术方式治疗剖宫产术后子宫瘢痕憩室的20例患者临床治疗疗效。结果 20例患者术前均行宫腔声学造影提示憩室肌层最薄处<3.0 mm,手术方式均采用宫腹腔镜联合下行子宫疤痕憩室整形折叠对接术,术后1月、3月随访,均行宫腔声学造影,90%患者提示瘢痕最薄处肌层较术前增加,平均厚度>5 mm,临床症状较前明显改善。结论此手术方式治疗子宫瘢痕憩室疗效显著,不仅能很好的改善阴道不规则流血的症状,对于迫切妊娠的高龄患者,明显缩短了术后避孕时间。

Objective To investigate the clinical value of hysteroscopy combined with laparoscopy in the treatment of uterine scar diverticulum with myometrial thickness less than 3 mm after cesarean section,and to analyze and evaluate the effect of this operation in the treatment of uterine scar diverticulum with myometrial thickness less than 3 mm.Methods A retrospective analysis of 20 cases of uterine scar diverticulum after cesarean section using this method surgery in our hospital from November 2018 to June 2019.Results All the 20 patients underwent sonohysterography before operation,which indicated that the thinnest muscular layer of the diverticulum was less than 3.0 mm.All the operations were performed by hysteroscopy combined with laparoscopic uterine scar diverticulum plastic folding surgery.Follow-up of 1 month and 3 months after operation,All patients were reexamined with sonohysterography.90%of the patients indicated that the thinnest muscular layer of the scar was increased with an average thickness of more than 5 mm and the clinical symptoms were improved significantly compared with preperative.Conclusion This operation is effective in treating uterine scar diverticulum,it not only lessen blood lost.Obviously it can shorten the controception time for aged women patient.