不同手术方式治疗剖宫产术后子宫切口憩室的疗效比较  

Analysis of the efficacy of different operations in treating patients with previous cesarean scar defect

作　　者：姚秀华[1] 祝文峰[1] 黄卓敏[1] 江旋[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院妇科,深圳518000

出　　处：《现代妇产科进展》2015年第8期580-582,共3页Progress in Obstetrics and Gynecology

摘　　要：目的:比较不同手术方式治疗剖宫产术后子宫切口憩室(PCSD)的疗效。方法:选择南方医科大学附属深圳妇幼保健院收治的69例PCSD患者,其中18例行宫腔镜电切术,23例行宫腹腔镜联合手术,28例行经阴道子宫切开憩室憩室修补术。比较3组患者的术后月经恢复情况及PCSD变化情况。结果:宫腹腔镜联合手术组和经阴手术组的月经改善总有效率分别为87%和86%,术后PCSD恢复有效率分别为91%和86%,均明显高于宫腔镜电切术组(50%,33%),差异均有统计学意义(P<0.05),前两组比较差异均无统计学意义(P>0.05)。结论:宫腹腔镜联合手术与阴式手术治疗PCSD的疗效相当,优于宫腔镜手术。3种手术各有优势,应根据具体情况选择术式,以达到最佳的治疗效果。Objective：To compare the efficacy of different operations in treating pa-tients with previous cesarean scar defect（PCSD）. Methods：Sixty-nine cases of PCSD were se-lected as study objects from Shenzhen Maternity and Child Healthcare Hospital of Southern Medical University,and divided into three groups due to different operation：18 cases were trea-ted with hysteroscope （group A）,23 cases were treated with hysteroscopy combined with lapa-roscopy（group B）,28 cases were treated with transvaginal uterine scar diverticulum resection（group C）. Results：Menstruation recovery after surgery：the response rate of group B（87% ） and group C （86% ） were significantly higher than that of group A（50% ）（P〈0. 05）. Postop-erative PCSD improvement：The response rate of group B（91% ） and group C （86% ） were sig-nificantly higher than that of group A（33% ）. There was no significant difference between group B and group C （P〉0. 05）. Conclusion：In therapeutic efficacy of PCSD,hysteroscopy combined with laparoscopy are similar with transvaginal uterine scar diverticulum resection and better than hysteroscope. Although three kinds of operation have different advantages and disadvantages,the operation method should be chosen depending on the individual condition to reach the best out-come.

关 键 词：子宫切口憩室 宫腔镜 腹腔镜 阴式手术 

分 类 号：R719.8[医药卫生—妇产科学]