宫腹腔镜联合手术治疗剖宫产术后子宫瘢痕憩室相关异常子宫出血患者的可行性分析  

Feasibility Analysis of Hysteroscope Combined Laparoscope Surgery in the Treatment of Patients with Cesarean Scar Diverticulum Related Abnormal Uterine Bleeding

作　　者：周君 杨美娟 彭如情 ZHOU Jun;YANG Meijuan;PENG Ruqing(Department of Obstetrics and Gynecology,Guixi People's Hospital,Guixi 335400,China;不详)

机构地区：[1]贵溪市人民医院妇产科,江西贵溪335400

出　　处：《中国医学创新》2024年第13期113-117,共5页Medical Innovation of China

摘　　要：目的:分析剖宫产术后子宫瘢痕憩室(CSD)相关异常子宫出血患者应用宫腹腔镜联合手术治疗的可行性。方法:回顾性分析2018年1月—2023年5月于贵溪市人民医院就诊的80例CSD相关异常子宫出血患者的临床资料,按照治疗方式的不同将其分为联合组(n=38)和基础组(n=42),其中基础组采用宫腔镜手术进行治疗,联合组采用宫腹腔镜联合手术治疗。比较两组患者的围手术期相关指标,观察两组术后月经改善率,对比两组子宫憩室深度,比较两组手术并发症(伤口感染、膀胱损伤、大出血)发生率。结果:联合组患者的手术用时显著长于基础组,差异有统计学意义(P<0.05);联合组患者的手术出血量少于基础组,排净恶露时间及住院时长均显著短于基础组,差异均有统计学意义(P<0.05)。联合组痊愈率高于基础组,好转率低于基础组,差异均有统计学意义(P<0.05);两组无效率及改善率比较,差异均无统计学意义(P>0.05)。术后,两组宫憩室深度情况均较术前显著改善(P<0.05);术后,两组子宫憩室深度情况比较,差异均无统计学意义(P>0.05)。两组伤口感染、膀胱损伤、大出血发生率比较,差异均无统计学意义(P>0.05),但联合组并发症总发生率显著低于基础组,差异有统计学意义(P<0.05)。结论:CSD相关异常子宫出血患者应用宫腹腔联合手术用时较长,但可加快术后康复及月经恢复正常,疗效与安全性较好。Objective:To analyze the feasibility of hysteroscope combined laparoscope surgery in the treatment of patients with cesarean scar diverticulum(CSD)related abnormal uterine bleeding.Method:The clinical data of 80 patients with CSD related abnormal uterine bleeding in Guixi People's Hospital from January 2018 to May 2023 were retrospectively analyzed.According to different treatment methods,they were divided into combined group(n=38)and basic group(n=42),in which the basic group was treated with hysteroscopy and the combined group was treated with hysteroscope combined laparoscope surgery.The perioperative related indexes of the two groups were compared.The improvement rate of menstruation after surgery of the two groups were observed.The depth of uterine diverticulum was compared between the two groups.The incidence of surgical complications(wound infection,bladder injury and massive bleeding)were compared between the two groups.Result:The operation time of patients in the combined group was significantly longer than that in the basic group,the difference was statistically significant(P<0.05).The surgical bleeding volume in the combined group was less than that in the basic group,and the time to clear lochia and the length of hospital stay were significantly shorter than those in the basic group,the differences were statistically significant(P<0.05).The recovery rate of the combined group was higher than that of the basic group,and the effective rate was lower than that of the basic group,the differences were statistically significant(P<0.05).There were no significant differences in the inefficiency and improvement rate between the two groups(P>0.05).After surgery,the depth of uterine diverticulum in both groups were significantly improved compared with that before operation(P<0.05).After surgery,there was no significant difference in the depth of uterine diverticulum between the two groups(P>0.05).There were no significant differences in the incidence of wound infection,bladder injury and massive bleeding between

关 键 词：剖宫产术后瘢痕憩室 异常子宫出血 宫腔镜 宫腹腔镜联合手术 

分 类 号：R719.8[医药卫生—妇产科学]