【摘要】 目的探讨临床常用治疗剖宫产切口憩室不同术式的疗效和安全性。方法采用回顾性研究方法,搜集2012年7月~2016年12月在四川大学华西第二医院妇科诊断剖宫产切口憩室且行手术治疗的住院患者的临床资料,并对患者进行随访。采用SPSS 22.0软件分析不同术式患者的围术期情况、术后缓解、复查情况等。结果共纳入125例患者,其中采用宫腔镜电切憩室活瓣组织并电凝憩室创面(电切活瓣组)的患者74例,其它术式切除憩室并切口缝合修补(切除憩室组)的患者51例。结果显示电切活瓣组在术中出血量、手术时间、肛门排气时间和住院时间等方面均优于切除憩室组,其差异均有统计学意义(P<0.001)。按不同术式进行两两比较,结果显示宫腔镜手术组在术中出血量、手术时间、肛门排气时间和住院时间等方面均最优,而开腹手术组最差。结论本研究结果显示宫腔镜电切憩室活瓣组织并电凝憩室创面是目前使用最多的术式,其具有直视、微创、简便、术后恢复快、并发症发生率低等优势,可能为治疗剖宫产切口憩室最佳选择术式。更多还原

【Abstract】 Objectives To analyze the efficacy and safety of different operation methods for patients withcesarean scar diverticulum. Methods The clinical data of patients with cesarean section scar diverticulum treated in WestChina Second University Hospital from July 2012 to December 2016 was collected and followed up. The data of theprevious perioperative period data, recovery, the improvement of the symptoms and postoperative condition of incisionhealing were analyzed by SPSS 22.0 software. Results A total of 125 patients were included, in which 74 cases receivedhysteroscopy surgery for diverticulum electro section and electric coagulation(ESEC group), and 51 cases received othersurgery focused on diverticulum dissection and sewing operations(DS group). Statistical analysis showed that, comparedwith DS group, bleeding, operation time, time of anal exsufflation and hospitalization duration after the operation ofhysteroscopy in ESEC group were significantly reduced(P<0.001). In addition, the results showed that hysteroscopy grouphad optimal results in hemorrhage volume, operation time, anal exhaust time and hospitalization time indicators.However, the results of laparotomy group was not significant. Conclusions For the treatment of CSD, surgical treatmentof this pathology by operative hysteroscopy may represent the best choice in symptomatic women because of its minimalinvasiveness and beneficial therapeutic results. Hysteroscopy isthmoplasty appears to be the most popular treatment.更多还原