3种手术方式治疗子宫切口憩室的疗效分析  

Analysis the Effect of Three Operation Methods in Treating Patients with Uterine Incision Diverticulum

作　　者：赵倩[1] 李哲[1] 秦玲[2] 王春芳[1] 海盼盼 

机构地区：[1]郑州大学第一附属医院,河南郑州450003 [2]郑州市妇幼保健院,河南郑州450012

出　　处：《实用妇产科杂志》2016年第4期286-288,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨宫腹腔镜联合修补术、阴式修补术和宫腔镜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:选择2008年2月至2012年5月在郑州大学第一附属医院收治的因保守治疗失败行手术治疗的剖宫产术后子宫切口憩室患者71例,其中接受宫腹腔镜联合手术治疗38例(宫腹腔镜组),经阴道手术治疗20例(阴式组)及宫腔镜治疗13例(宫腔镜组)。回顾性分析71例患者手术的相关统计指标。结果:宫腹腔镜组、阴式组和宫腔镜组在术中出血量(35.0±17.6 ml、25.0±15.8 ml、10.0±10.2 ml)、手术时间(60.0±12.4分钟、43.0±15.6分钟、20.0±5.6分钟)、术后阴道流血时间(7.9±2.1天、9.5±3.5天、5.5±3.2天)和治疗费(15283.6±756.3元、5269±332.4元、7841.9±965.8元)方面比较,差异均有统计学意义(P<0.001)。宫腹腔镜组治疗月经改善有效率(97.14%)与阴式组(94.74%)比较,差异无统计学意义(P>0.05),但两组分别与宫腔镜组(63.64%)比较差异均有统计学意义(P<0.05)。3组术后妊娠率分别为72.73%(8/11)、60.00%(3/5)、50.00%(2/4),比较差异无统计学意义(P>0.05)。结论:宫腹腔镜、宫腔镜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及医者水平制定相应的手术治疗方案。Objective：To analyze the clinical effects of three methods（including hysteroscopy combined with laparoscopy,vaginal operation or hysteroscope） of treatment to the uterine incision diverticulum, and to provide reference for choosing sugery program of the uterine incision diverticulum. Methods：The clinical data of 71 pa- tients who had previous cesarean scar defect from Feb 2008 to May 2012 in the first affiliated hospital of Zheng- zhou university were retrospectively reviewed. Among them,38 cases were performed hysteroscopic combined with laparoscopic surgery（combined group） ,20 patients underwent vaginal surgery（vaginal group） and others13 cases had hysteroscopic operation（hysteroscopy group）. The reltated indexes of the 71 cases were analyzed in this study. Results： The amount of bleeding （35.0 ± 17.6 ml,25.0 ± 15.8 ml, 10.0 ± 10.2 ml）, operation time （60.0 ±12.4 min,43.0 ±15.6 min,20.0 -±5.6 min） ,time of vaginal bleeding after operation（7. 9 ±2. 1 day,9.5 ±3. 5 day,5.5 ±3.2 day） and hospitalization costs（15283.6 ±756.3 yuan,5269 ±332.4 yuan,7841.9 ±965.8 yuan） of the three groups （combined group, vaginal group, hysteroscopy group） were compared, the difference was statistically significant（ P 〈 0. 001 ）. The menstruation improvement rate was 97. 14% and 94.74% in com- bined group and vaginal group, respectively, the difference between the two groups had no statistical significance （P 〉0.05）. And the menstruation improvement rates in both combined group and vaginal group were statistically higher than that in hysteroscopy group（63.64% ） （ P 〈 0.05）. The pregnancy rate among the three groups was 72.73% （8/11 ）,60. 00% （3/5）,50.00% （2/4）, respectively, and the difference among them had no statistical significance （ P 〉 0.05）. Conclusions： All the three methods （ including hysteroscopy combined with laparoscopy, vaginal operation or hysteroscope） are effective in treating uterine incision diverticulum. Different me

关 键 词：子宫切口憩室 宫腹腔镜联合手术 宫腔镜手术 阴式手术 

分 类 号：R713[医药卫生—妇产科学]