剖宫产术后子宫疤痕缺损的治疗  

Treatment of uterine scar defect after cesarean section

作　　者：郭玲[1] 

机构地区：[1]清远市人民医院,广东清远511518

出　　处：《包头医学院学报》2017年第8期4-6,共3页Journal of Baotou Medical College

基　　金：清远市科技计划项目(44011120143410k)

摘　　要：目的:观察剖宫产术后子宫疤痕缺损的手术治疗效果。方法:选取100例剖宫产后子宫疤痕缺损患者为研究对象,采用宫腔镜电切手术法的50例患者为宫腔镜手术组,采用阴式子宫瘢痕修补术的50例患者为阴式手术组,观察两组患者的治疗效果及并发症情况。结果:宫腔镜手术组患者手术时间短于阴式手术组(t=4.363,P=0.014),且术中出血量少于阴式手术组(t=3.753,P=0.025);与阴式手术组相比,宫腔镜手术组患者的术后肛门排气时间较短(t=3.823,P=0.023)、住院时间较短(t=3.063,P=0.033)、住院费用较高(t=3.563,P=0.027);宫腔镜手术组患者的术后并发症发生率低于阴式手术组(χ~2=3.368,P=0.029);阴式手术组患者术后2个月经期恢复正常率高于宫腔镜组(χ~2=3.263,P=0.037),且术后6个月经期恢复正常率也高于宫腔镜手术组(χ~2=3.632,P=0.035);子宫后位是子宫剖腹产缺损形成的危险因素(β=1.098,OR=2.998,χ~2=5.289,P=0.023,95%CI=1.176-7.639)。结论:采取手术治疗剖宫产后子宫疤痕缺损,有明确治疗效果,可根据患者具体情况合理地选择手术方式。Objective： To explore the effects of surgical treatment on uterine scar defect after cesarean section. Methods： 100 cases of patients with uterine scar defect after cesarean section were selected as the research objects. 50 cases treated by hysteroscopic resection（ 50 cases） were in hysteroscopic surgery group and 50 cases treated by vaginal uterine scar repair were in vaginal operation group. The therapeutic effects and complications situation were observed in the two groups. Results： The operation time in hysteroscopic surgery group was shorter than that in vaginal operation group（ t = 4. 363,P = 0. 014） and the intraoperative blood loss was less than that in vaginal operation group（ t = 3. 753,P = 0. 025）. The postoperative anal exhaust time,hospitalization time and hospitalization cost were lower than those in hysteroscopic surgery group（ t = 3. 823,P = 0. 023; t = 3. 063,P = 0. 033; t = 3. 563,P = 0. 027）. The incidence of complications in hysteroscopic surgery group was lower than that in vaginal operation group（ χ2= 3. 368,P = 0. 029）. The normal rates of menstrual recovery after 2 months and after 6 months in vaginal surgery group were significantly higher than those in hysteroscopic surgery group（ χ2= 3. 263,P = 0. 037; χ2= 3. 632,P = 0. 035）. The posterior uterus was a risk factor for the formation of uterine caesarean section（ β = 1. 098,OR = 2. 998,χ2= 5. 289,P = 0. 023,95 % CI = 1. 176-7. 639）. Conclusion： The surgical treatment of uterine scar defect after cesarean section is effective and the surgical way can be reasonably selected according to the specific situation of the patients.

关 键 词：剖腹产 疤痕缺损 治疗 

分 类 号：R719.8[医药卫生—妇产科学]