剖宫产瘢痕憩室的三种术式疗效比较  

Comparison of three types of surgery for cesarean scar diverticulum

作　　者：诸充 瞿思昱 李书勤 ZHU Chong;QU Siyu;LI Shuqin(Department of Obstetrics&Gynecology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院妇产科,安徽芜湖241001

出　　处：《皖南医学院学报》2021年第1期36-39,共4页Journal of Wannan Medical College

基　　金：安徽高校自然科学研究项目(KJ2015A142)。

摘　　要：目的:分析治疗剖宫产瘢痕憩室(CSD)3种手术方式的疗效差异。方法:选择2012年12月~2019年12月弋矶山医院妇产科CSD患者60例,其中宫腔镜CSD修复术(宫腔镜组)36例,阴式CSD修复术(阴式组)14例,腹腔镜CSD修复术(腹腔镜组)10例。对3组患者的经期、手术时间、术中失血、住院时间等指标进行统计分析。结果:3组患者的年龄、剖宫产次数和经期之间差异无统计学意义(P>0.05)。宫腔镜组手术时间、术中失血量和住院时间均少于腹腔镜组和阴式组(F=139.674,P<0.001;F=22.14,P<0.001;F=15.405,P<0.001),对患者进行6~36个月随访后发现3种手术方式的有效率和复发率差异无统计学意义(P>0.05)。结论:3种术式对CSD的疗效差异无统计学意义,如果患者有生育能力,则需要合理选择手术方法。Objective:To compare the outcomes of three surgical modalities for treatment of cesarean scar diverticulum(CSD).Methods:Sixty patients with CSD were treated in our hospital during December 2012 and 2019 by hysteroscopic repair(hysteroscopy group,n=36),vaginal surgery for repair of cesarean scar diverticula(vaginal group,n=14)and laparoscopic scar diverticulum repair(laparoscopy group,n=10),respectively.The indicators,including menstrual period before and after operation,operative time,intraoperative blood loss and length of hospital stay,were statistically analyzed in the three groups,and compared among groups with single factor variance analysis and randomized block design analysis of variance.Results:There was no statistical difference in patient′s age,cesarean delivery times and periods among the three groups(P>0.05).Patients treated with hysteroscopy had shorter operative time,lower intraoperative blood loss and reduced hospital stay than those treated by laparoscopy and vaginal surgery(F=139.674,P<0.001;F=22.14,P<0.001;F=15.405,P<0.001,respectively).6-36 months of follow-up showed no significant difference in efficacies and relapse rate for patients treated by any of the surgical modality(P>0.05).Conclusion:There is no difference in the three surgical modalities for treatment of CSD,yet surgical option is still necessary for patients with fertility needs.

关 键 词：瘢痕憩室 宫腔镜瘢痕憩室修复术 阴式瘢痕憩室修复术 腹腔镜瘢痕憩室修复术 疗效 

分 类 号：R719.8[医药卫生—妇产科学]