宫腔镜辅助经阴道修补术治疗剖宫产瘢痕憩室临床效果的对比观察  

Clinical efficacy of hysteroscopy-assisted transvaginal repair for treatment of cesarean scar defect

作　　者：周丹[1] 梁琳[1] 吕秋波[1] 张巧[1] ZHOU Dan;LIANG Lin;LV Qiubo;ZHANG Qiao(Beijing Hospital,National Center of Gerontology,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing,100730)

机构地区：[1]北京医院国家老年医学中心中国医学科学院老年医学研究院,100730

出　　处：《中国计划生育学杂志》2021年第6期1117-1119,共3页Chinese Journal of Family Planning

基　　金：北京市科技计划项目(Z191100006619018)。

摘　　要：目的:评价在有生育要求的瘢痕憩室患者中行宫腔镜辅助下阴道子宫瘢痕憩室修补术和宫腔镜电切法的治疗效果。方法:回顾性分析2014年1月-2019年1月北京医院妇产科收治的93例剖宫产瘢痕憩室患者临床资料,其中行宫腔镜电切术45例(宫腔镜电切组),行宫腔镜辅助下经阴道修补术48例(阴式手术组),比较两组术中术后情况。结果:在手术时间、术中出血量、肛门排气时间、术中术后并发症、住院时间方面两组无差异(P>0.05);术后出血时间阴式手术组短于宫腔镜电切组(P<0.05)。随访6个月,阴式手术组组子宫肌层厚度(9.7±1.0mm)大于宫腔镜电切组的(3.2±0.7mm)(P<0.05);阴式手术组1例因手术并发症转行开腹手术。阴式手术组足月活产率(93%)高于宫腔镜电切组(47%)(P<0.05)。结论:宫腔镜辅助下经阴道子宫瘢痕憩室修补术较宫腔镜电切法临床疗效好,术后足月活产率高。Objective:To evaluate the clinical efficacy of hysteroscopy-assisted transvaginal repair and hysteroscopy electrocauterization for treating cesarean scar defect(CSD)of the patients with desire to conceive in future.Methods:93 patients with CSD who had desire to conceive in future between January 2014 and January 2019 were analyzed retrospectively.Based on different treatment methods,these patients were divided into 45 patients treated by electrocauterization in group A and 48 patients treated by hysteroscopy-assisted transvaginal repair in group B.Perioperative and postoperative situations of the patients were compared between the two groups.Results:The operation time,the intraoperative blood loss,the time of passing flatus,the perioperative and postoperative complications rates,and duration of hospitalization of the patients had no significant different between the two groups(P>0.05).The postoperative bleeding time of the patients in group B was significant shorter than that of the patients in group A(P<0.05).After 6 months of followed up,the thickness of myometrium(9.7±1.0 mm)of the patients in group B was significant thicker than that(3.2±0.7 mm)of the patients in group A(P<0.05).One patient in group B was transferred to laparotomy due to surgical complications.The live birth rate(93%)of the patients in group B was significant higher than that(47%)of the patients in group A(P<0.05).Conclusion:Hysteroscopy-assisted transvaginal repair for treating CSD has better clinical effect with higher full-term birth rate as compared to that of hysteroscopy electrocauterization.

关 键 词：子宫瘢痕憩室 宫腔镜辅助下经阴道子宫瘢痕憩室修补术 宫腔镜电切 

分 类 号：R713[医药卫生—妇产科学]