两种路径折叠对接缝合法治疗剖宫产瘢痕憩室的疗效  

作　　者：黄凌霄 周秀静 沙丽晓 林晓华 

机构地区：[1]温州市人民医院,325000

出　　处：《浙江临床医学》2024年第5期694-696,共3页Zhejiang Clinical Medical Journal

基　　金：温州市基础性科研项目(Y2020497)。

摘　　要：目的对比腹腔镜和阴式子宫瘢痕折叠对接缝合法治疗剖宫产瘢痕憩室的临床疗效。方法选取2021年1月至2022年12月本院收治的剖宫产瘢痕憩室患者60例,随机分为腹腔镜组和阴式组,各30例。腹腔镜组行宫腔镜检查联合腹腔镜下子宫瘢痕折叠对接缝合术,阴式组行宫腔镜检查联合经阴道子宫瘢痕折叠对接缝合术,对比两组围手术期指标、术后3个月憩室修复情况及月经恢复情况,并行统计分析。结果两组术中出血量、住院时间差异无统计学意义(P>0.05),腹腔镜组手术时间长于阴式组(P=0.020),住院费用高于阴式组(P<0.001);腹腔镜组与阴式组比较,术后3个月经期延长改善的治愈率及有效率差异均无统计学意义(P>0.05),术后3个月憩室修复的治愈率及有效率差异均无统计学意义(P>0.05)。结论腹腔镜及经阴道两种路径下折叠对接缝合法对剖宫产瘢痕憩室的治疗效果相当。经阴道途径手术费用更低,体表无创口,真正体现微创理念,值得临床推广。Objective To compare the efficacy of laparoscopic and transvaginal"folding suture method"as a surgical procedure for the treatment of cesarean scar diverticulum(CSD).Methods Sixty patients with CSD after cesarean section admitted to Wenzhou People's Hospital from January 2021 to December 2022 were selected as study subjects.According to the random number table method,patients were divided into the laparoscopic group(LAP group)and the transvaginal group(TV group),with 30 cases in each group.Patients in LAP group were treated by hysteroscopy and laparoscopic folding suture method,while TV group were treated by hysteroscopy and transvaginal folding suture method.The operation and clinical effects of the two groups were observed.Results There was no significant difference in intraoperative blood loss and hospitalization time between the two groups(P>0.05).The operation duration of the LAP group were longer than those of the TV group(P=0.020),the hospitalization expenses of the LAP group were more than those of the TV group(P<0.001).The cure rate and effective rate of improvement in prolonged menstruation at 3 months after operation between the LAP and TV group were of no significant difference(P>0.05).The cure rate and effective rate of diverticulum repair at 3 months after operation between the LAP and TV group were of no significant difference(P>0.05).Conclusion The outcomes of laparoscopic and transvaginal"folding suture method"for the treatment of CSD are comparable.The transvaginal procedure is less costly and truly minimally invasive,making it worthy of clinical promotion.

关 键 词：剖宫产瘢痕憩室 折叠对接缝合 腹腔镜 阴式手术 

分 类 号：R719.8[医药卫生—妇产科学]