子宫瘢痕憩室切除对二次剖宫产产妇的影响  

Effect of Excision of Uterine Scar Diverticulum on Parturients After Second Cesarean Section

作　　者：陈慧 林清兰 陈颖文 王冬纳 张燕 余艳萍 CHEN Hui;LIN Qinglan;CHEN Yingwen;WANG Dongna;ZHANG Yan;YU Yanping(Department of Obstetrics and Gynecology,Xiaolan Hospital Affiliated to Southern Medical University,Zhongshan 528415,China)

机构地区：[1]南方医科大学附属小榄医院妇产科,广东中山528415

出　　处：《河南医学研究》2021年第22期4061-4063,共3页Henan Medical Research

基　　金：中山市医学科研项目(2019A020348)。

摘　　要：目的探讨原有子宫瘢痕憩室切除对二次剖宫产产妇的影响。方法回顾性分析2018年1月至2020年1月南方医科大学附属小榄医院收治的239例子宫瘢痕憩室患者的临床资料,患者均接受二次剖宫产。其中将手术中不切除原有瘢痕憩室而直接缝合的137例患者纳入对照组,将手术中切除原有瘢痕憩室的102例患者纳入切除组。采用倾向性得分匹配法(PSM)按1∶1匹配,卡钳值取0.06,匹配后两组各有54例患者。比较两组住院时间、术中出血量、手术时间、术后血红蛋白(Hb)。术后随访1 a,统计术后阴道异常流血、剖宫产术后子宫瘢痕憩室(CSD)、憩室残余厚度及憩室容积。结果两组住院时间、术中出血量、手术时间、术后Hb比较,差异无统计学意义(P>0.05)。切除组术后异常阴道流血率和CSD形成率较对照组低(P<0.05)。切除组瘢痕憩室残余子宫肌层厚度值较对照组大,瘢痕憩室容积较对照组小(P<0.05)。结论在二次剖宫产时,切除原有瘢痕憩室可减少术后CSD的形成,减轻CSD形成的程度。Objective To investigate the effect of the resection of the original uterine scar diverticulum on the parturients after the second cesarean section.Methods The clinical data of 239 patients with uterine scar diverticulum admitted to Xiaolan Hospital Affiliated to Southern Medical University from January 2018 to January 2020 were retrospectively analyzed.All patients received second cesarean section.Among them,137 patients who were sutured directly without removing the original scar diverticulum during the operation were included in control group,and 102 patients who had the original scar diverticulum removed during the operation were included in resection group.Propensity score matching method(PSM)was used for 1∶1 matching,and the caliper value was 0.06.After matching,there were 54 patients in each of the two groups.The hospitalization time,intraoperative blood loss,operation time and postoperative hemoglobin(Hb)were compared between the two groups.After operation for 1 year follow-up,abnormal vaginal bleeding,CSD,residual thickness of diverticulum and volume of diverticulum were counted.Results There was no statistical difference in hospitalization time,intraoperative blood loss,operation time and postoperative Hb between the two groups(P>0.05).The rates of abnormal vaginal bleeding and CSD formation in resection group were lower than those in control group(P<0.05).The thickness of residual myometrium of scar diverticulum in resection group was larger than that in control group,and the volume of scar diverticulum was smaller than that in control group(P<0.05).Conclusion In the second cesarean section,the removal of the original scar diverticulum could reduce the formation of postoperative CSD and reduce the degree of CSD formation.

关 键 词：子宫瘢痕憩室 二次剖宫产 倾向性得分匹配法 瘢痕切除 

分 类 号：R719.8[医药卫生—妇产科学]