宫腔镜联合腹腔镜手术治疗剖宫产瘢痕憩室疗效的影响因素  

Analysis of Influencing Factors of Hysteroscopy Combined with Laparoscopy in the Treatment of Cesarean Scar Diverticulum

作　　者：裴益明 刘润萍[2] PEI Yi-ming;LIU Run-ping(Department of Clinical Laboratory,The First People's Hospital of Xianyang,Xianyang Shaanxi,712000)

机构地区：[1]咸阳市第一人民医院检验科,陕西咸阳712000 [2]汉中市人民医院妇产科,陕西汉中723000

出　　处：《医学临床研究》2022年第6期812-814,818,共4页Journal of Clinical Research

基　　金：中华国际科学交流基金会检验检测科技专项项目(Z2019LSXB008)。

摘　　要：【目的】探讨宫腔镜联合腹腔镜手术治疗剖宫产瘢痕憩室疗效的影响因素。【方法】选择2019年4月至11月在咸阳市第一人民医院行宫腔镜联合腹腔镜手术治疗的96例剖宫产瘢痕憩室患者,术后6个月,根据患者恢复情况分为恢复不良组和恢复良好组,比较两组患者体重指数、孕次、血红蛋白(Hb)、白细胞(WBC)、白蛋白(ALB)水平等临床资料,采用多因素Logistic回归分析手术治疗剖宫产瘢痕憩室疗效的影响因素。【结果】术后6个月,经B超复查显示23例可见憩室仍存在,占23.96%,纳入恢复不良组;73例患者超声检查无憩室,占76.04%,纳入恢复良好组。恢复不良组体重指数、剖宫产次数、憩室深度及后位子宫占比均显著高于恢复良好组,Hb水平低于恢复良好组,其差异均有统计学意义(P<0.05);但两组年龄、流产史、孕次、手术距末次剖宫产时间、邻近子宫肌层厚度及WBC、ALB水平比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示:剖宫产次数(OR=1.134,95%CI=1.086~1.184)、子宫位置(OR=1.845,95%CI=1.264~2.693)、憩室深度(OR=1.645,95%CI=1.184~2.285)、Hb水平(OR=1.421,95%CI=1.117~1.808)是宫腔镜联合腹腔镜手术治疗剖宫产瘢痕憩室疗效的独立影响因素(P<0.05)。【结论】剖宫产次数、子宫位置、憩室深度、Hb水平是宫腔镜联合腹腔镜手术治疗剖宫产瘢痕憩室疗效的独立影响因素,临床应引起重视。【Objective】To explore the influencing factors of hysteroscopy combined with laparoscopy in the treatment of cesarean scar diverticulum.【Methods】A total of 96 patients with cesarean scar diverticulum who underwent hysteroscopy combined with laparoscopy in The First People's Hospital of Xianyang from April to November 2019 were selected.Six months after operation,they were divided into poor recovery group and good recovery group according to their recovery.The clinical data of body mass index,pregnancy times,hemoglobin(HB),white blood cell(WBC),albumin(ALB)and other levels were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of surgical treatment of cesarean scar diverticulum.【Results】At 6 months after operation,23 cases(23.96%)with diverticulum were found by B-ultrasonography,and were included in the poor recovery group;73 patients(76.04%)without diverticulum were included in the good recovery group.The body mass index,the number of cesarean section,the depth of diverticulum and the proportion of posterior uterus in the poor recovery group were significantly higher than those in the good recovery group,and the level of Hb was lower than that in the good recovery group(P<0.05);However,there was no significant difference between the two groups in terms of age,history of abortion,times of pregnancy,time from operation to the last cesarean section,thickness of adjacent myometrium,WBC and ALB levels(P>0.05).Multivariate logistic regression analysis showed that the number of cesarean sections(OR=1.134,95%CI=1.086~1.184),uterine position(OR=1.845,95%CI=1.264~2.693),diverticulum depth(OR=1.645,95%CI=1.184~2.285)and Hb level(OR=1.421,95%CI=1.117~1.808)were independent influencing factors on the efficacy of hysteroscopic combined with laparoscopic surgery for cesarean scar diverticulum(P<0.05).【Conclusion】The frequency of cesarean section,uterine position,diverticulum depth and Hb level are the independent influencing factors of hysteroscopy combin

关 键 词：剖宫产术 瘢痕 憩室 宫腔镜检查 

分 类 号：R714[医药卫生—妇产科学]