目的：比较宫、腹腔镜联合手术与阴式手术修补治疗剖宫产术后子宫切口憩室的临床效果。方法选择符合标准的患者60例，随机分为观察组和对照组，每组各30例。观察组采用宫、腹腔镜联合手术，对照组采用阴式手术，比较两组患者的手术及随访情况。结果两组患者在术中出血量、手术时间、肛门排气时间、术后阴道出血时间及术后住院时间比较，差异有统计学意义（P<0.05）。观察组患者优良率86.67%，高于对照组的66.67%，差异有统计学意义（P<0.05）。观察组患者并发症发生率10.00%，对照组患者并发症发生率33.33%，差异有统计学意义（P<0.05）。随访>1年，观察组86.67%患者月经恢复正常，彩超提示13.33%的患者有3~4 mm小憩室，对照组63.33%月经恢复正常，36.67%的患者有3~4 mm小憩室，差异有统计学意义（P<0.05）。结论阴式手术修补剖宫产术后子宫切口憩室术中出血量少，手术时间短，对胃肠道干扰小，但是宫、腹腔镜联合手术临床疗效好，并发症发生率低。%Objective To compare the clinical effects of laparoscopy combined with hysteroscopy vs. transvaginal surgery in repair of cesarean section scar diverticula.Methods A total of 60 eligible patients were selected, and randomly divided into observation group and control group, with 30 patients in each group. The observation group used laparoscopy combined with hysteroscopy, while the control group used transvaginal surgery, and the conditions of surgery and follow up were compared between the two groups.Results The differences in intraoperative blood loss, operative time, times to passage of gas by anus, postoperative vaginal bleeding time, and postoperative length of stay were statistically significant (P<0.05). The good rate of the observation group was 86.67%, higher than that of the control group (66.67%), and the difference was statistically significant (P<0.05). The incidences of complications of the observation group and the control group were 10.00% and 33.33%, respectively, and the difference was statistically significant (P<0.05). All the patients were followed up for 1 year, 86.67% patients of the observation group had their menstruation recovered normal, and 13.33% of the observation group had 3-4mm small diverticula as suggested by color ultrasonography; while 63.33% patients of the control group had their menstruation recovered normal, and 36.67% of the control group had 3-4mm small diverticula as suggested by color ultrasonography; and the differences were statistically significant (P<0.05).Conclusion Transvaginal surgery in repair of cesarean section scar diverticula has advantages of less intraoperative blood loss, shorter operative time, and less interference in gastrointestinal tract, while laparoscopy combined with hysteroscopy has advantages of better clinical therapeutic effects and lower complication incidence.
展开▼
