宫腹腔镜联合修补术与宫腔镜电切开渠术治疗剖宫产术后子宫瘢痕憩室患者的效果比较  

Comparison of effects of hysteroscopic combined with laparoscopic repair and hysteroscopic electrotomy in treatment of patients with previous cesarean scar defect after cesarean section

作　　者：杨慢慢 YANG Manman(Department of Gynecology of Kaifeng Obstetrics and Gynecology Hospital,Kaifeng 475000 Henan,China)

机构地区：[1]开封市妇产医院妇科,河南开封475000

出　　处：《中国民康医学》2024年第21期151-154,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较宫腹腔镜联合修补术与宫腔镜电切开渠术治疗剖宫产术后子宫瘢痕憩室(PCSD)患者的效果。方法:回顾性分析2020年2月至2022年10月该院收治的87例PCSD患者的临床资料,按照手术方法不同将其分为对照组43例和观察组44例。对照组行宫腔镜电切开渠术治疗,观察组行宫腹腔镜联合修补术治疗。比较两组围术期指标(手术时间、术中出血量、住院时间、治疗费用)水平、临床疗效、手术前后月经期、并发症发生率和术后1年自然妊娠率。结果:观察组手术时间、住院时间长于对照组,术中出血量多于对照组,治疗费用高于对照组,差异均有统计学意义(P<0.05);观察组治疗总有效率为93.18%(41/44),高于对照组的76.74%(33/43),差异有统计学意义(P<0.05);术后3个月,观察组月经期短于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);术后1年,观察组自然妊娠率为25.00%(11/44),高于对照组的6.98%(3/43),差异有统计学意义(P<0.05)。结论:宫腹腔镜联合修补术治疗PCSD患者可提高治疗总有效率和自然妊娠率,缩短月经期,效果优于宫腔镜电切开渠术治疗,但会延长手术时间和住院时间,增加术中出血量和治疗费用。Objective:To compare effects of hysteroscopic combined with laparoscopic repair and hysteroscopic electrotomy in treatment of patients with previous cesarean scar defect(PCSD)after cesarean section.Methods:The clinical data of 87 patients with PCSD admitted to the hospital from February 2020 to October 2022 were retrospectively analyzed.According to different surgical methods,they were divided into control group(43 cases)and observation group(44 cases).The control group was treated with hysteroscopic electrotomy,while the observation group was treated with hysteroscopic combined with laparoscopic repair.The perioperative indexes(operation time,intraoperative blood loss,hospitalization time,treatment cost)levels,the clinical efficacy,the menstrual period before and after the surgery,the incidence of complications,and the natural pregnancy rate 1 year after the surgery were compared between the two groups.Results:The operation time and the hospitalization time of the observation group were longer than those of the control group,the intraoperative blood loss was more than that of the control group,the treatment cost was higher than that of the control group,and the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 93.18%(41/44),which was higher than 76.74%(33/43)in the control group,and the difference was statistically significant(P<0.05).Three months after the surgery,the menstrual period of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).One year after the surgery,the natural pregnancy rate of the observation group was 25.00%(11/44),which was higher than 6.98%(3/43)of the control group,and the difference was statistically significant(P<0.05).Conclusions:Hysteroscopic combined with laparoscopic in the treatment of the PCSD patients can improve the total effective rate and the

关 键 词：剖宫产术后子宫瘢痕憩室 宫腹腔镜联合修补术 宫腔镜电切开渠术 月经期 自然妊娠率 出血量 并发症 

分 类 号：R713.4[医药卫生—妇产科学]