宫腹腔镜联合手术与阴式手术治疗剖宫产术后子宫切口憩室的效果比较  

Curative effect comparison of hysteroscopy combined with laparoscopy operation and transvaginal operation treatment of patients after cesarean section uterine incision diverticulum

作　　者：张先华[1] 陈哲[1] 费梦[1] 

机构地区：[1]湖北省荆州市第二人民医院妇产科,434000

出　　处：《中国综合临床》2015年第1期63-66,共4页Clinical Medicine of China

摘　　要：目的探讨宫腹腔镜联合修补术和阴式修补术治疗剖宫产术后子宫切口憩室的临床疗效，为临床手术方案的选择提供参考。方法选取我院收治的剖宫产术后子宫切口憩室患者52例，随机分为观察组和对照组各26例。观察组采用宫腹腔镜联合修补术进行治疗，对照组采用阴式修补术进行治疗，对比两组患者的手术时间、术中出血量、术后肛门首次排气时间、术后最高体温和住院天数，同时评价两组患者术后3个月的经期恢复和子宫憩室的修复情况。结果观察组的手术时间为（119．91±35．73）min，对照组的手术时间为（62．32±31．83）min，观察组的手术时间显著长于对照组（t=3．514，P〈0．05）；两组患者的术中出血量、肛门首次排气时间、术后最高体温和术后住院天数比较，差异均无统计学意义（P均〉0．05）；经过治疗后，观察组经期恢复的总有效率为84．62％，对照组经期恢复的总有效率为88．46％；经过B超复查，观察组术后子宫憩室修复的总有效率为84．62％，对照组术后子宫憩室修复的总有效率为88．46％。两组患者经期恢复情况和子宫憩室修复情况的对比，差异均无统计学意义（0值分别为1．14、1．76，P均〉0．05）。结论宫腹腔镜修补术和阴式修补术均是剖宫产术后子宫切口憩室的有效治疗手段，临床上可根据患者的病情制定相应的手术治疗方案。Objective To investigate the clinical efficacy of uterine incision diverticulum type repair after cesarean section treated by laparoscopy and transvaginal combined with repair in order to provide the reference for the clinical operation scheme selection. Methods Fifty-two patients who underwent uterine incision diverticulum type repair after cesarean section in the Second People＇s Hospital of Jingzhou were randomly divided into observation group and control group with 26 cases in each. Patients in the observation group were treated with laparoscopy combined with repair treatment, and patients in the control group were treated with transvaginal repair treatment. The operation periods, cut bleeding volume, postoperative anal exhaust time for the first time, postoperative highest temperature and length of hospital stay were recorded to evaluate the repair and uterine diverticula recovery at 3 months after operation. Results The operation periods in the observation group was （119. 91±35.73） min,longer than that in the control group（ （62. 32 ± 31.83） min;t =3.514,P 〈0.05）. There were on significant differences between two groups in terms of the amount of bleeding, anal discharge first time,the highest postoperative temperature and contrast after a few days in hospital （P 〉 0.05 ）. After treatment, the observation group menstrual recovery rate was 84. 62% and 88.46% in the control group. The differences were not statistically significant （ Xz = 1.14, 1.76, P 〉 0. 05 ）. Conclusion Laparoscopy herniorrhaphy and transvaginal repair are effective treatment for uterine incision diverticulum after caesarean operation. The corresponding treatment plan can be made according to the patient＇s condition.

关 键 词：宫腹腔镜联合手术 阴式手术 剖宫产 子宫切口憩室 

分 类 号：R714.224[医药卫生—妇产科学]