腹腔镜下子宫瘢痕折叠缝合术治疗剖宫产术后子宫瘢痕憩室的疗效观察  

Clinical efficacy of laparoscopic uterine scar folding suture on cesarean scar diverticulum

作　　者：靳新星 赵晓娟 高庆[1,3] JIN Xin-xing;ZHAO Xiao-juan;GAO Qing(Xi'an Jiaotong University,Xi'an 710061,Shaanxi,CHINA;Department of Gynecology,the First People's Hospital of Xianyang,Xianyang 712000,Shaanxi,CHINA;Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,Shaanxi,CHINA)

机构地区：[1]西安交通大学,陕西西安710061 [2]咸阳市第一人民医院妇科,陕西咸阳712000 [3]西安交通大学第二附属医院妇产科,陕西西安710000

出　　处：《海南医学》2025年第4期493-496,共4页Hainan Medical Journal

基　　金：陕西省重点研发计划项目(编号:2019SF-021)。

摘　　要：目的观察腹腔镜下子宫瘢痕折叠缝合术治疗剖宫产术后子宫瘢痕憩室(CSD)的疗效。方法回顾性分析2022年3月至2024年7月期间在咸阳市第一人民医院行手术治疗的95例CSD患者的临床资料,依据手术方式分为切除组(行腹腔镜下子宫瘢痕憩室切除缝合术)42例和折叠组(行腹腔镜下子宫瘢痕憩室折叠缝合术)53例。比较两组患者的临床资料、术中和术后指标、憩室深度修复效果、经期延长改善效果以及并发症发生情况。结果折叠组患者的手术时间为(70.85±20.31)min,明显短于切除组的(86.32±20.43)min,术中出血(49.27±12.47)mL,明显少于切除组的(61.54±15.14)m L,差异均有统计学意义(P<0.05),但两组患者的术后最高体温、留置导尿管及住院时间比较差异均无统计学意义(P>0.05);切除组、折叠组患者的憩室深度修复总有效率分别为98.11%、95.24%,经期延长改善总有效率分别为100.00%、95.24%,两组比较差异均无统计学意义(P>0.05);折叠组患者的术后并发症总发生率为3.77%,明显低于切除组的16.67%,差异有统计学意义(P<0.05)。结论腹腔镜下子宫瘢痕憩室折叠与切除缝合术均具备良好子宫瘢痕憩室修复和经期延长改善效果,腹腔镜下子宫瘢痕憩室折叠缝合术相较于切除缝合术能够有效下调术中出血,缩短手术用时,降低并发症风险,可作为CSD治疗首选术式。Objective To observe the efficacy of laparoscopic uterine scar folding suture in the treatment of cesarean scar diverticulum(CSD).Methods The clinical data of 95 patients with CSD who received surgical treatment in the First People’s Hospital of Xianyang were retrospectively analyzed from March 2022 to July 2024.According to the surgical methods,the above patients were divided into resection group(laparoscopic resection suture for uterine scar diverticulum,n=42)and folding group(laparoscopic folding suture for uterine scar diverticulum,n=53).The clinical basic data,intraoperative and postoperative indexes,repair effect of diverticulum depth,improvement effect of prolonged menstruation,and the complications were compared between the resection group and the folding group.Results The operative duration in the folding group was significantly shorter than that in the resection group:(70.85±20.31)min vs(86.32±20.43)min,and the intraoperative blood loss was significantly less:(49.27±12.47)mL vs(61.54±15.14)mL,with statisti-cally significant differences(P<0.05).However,there were no statistically significant differences in postoperative maxi-mum body temperature,urinary catheter indwelling time,and length of hospital stay between the resection group and the folding group(P>0.05).The total effective rates of repairing diverticulum depth in the resection group and the folding group were 98.11%and 95.24%(P>0.05),and the total effective rates of improving prolonged menstruation were 100.00%and 95.24%,respectively(P>0.05).The total incidence rate of complications was 3.77%in the folding group,which was significantly lower than 16.67%in the resection group(P<0.05).Conclusion Both laparoscopic folding and resection suture for uterine scar diverticulum have good effect in repairing uterine scar diverticulum and improving prolonged menstruation.Laparoscopic folding suture for uterine scar diverticulum can more effectively reduce intraoper-ative blood loss,shorten the operative duration,and lower the risk of complications co

关 键 词：腹腔镜 折叠缝合术 剖宫产术后子宫瘢痕憩室 疗效 

分 类 号：R719.8[医药卫生—妇产科学]