【摘要】 目的观察腹腔镜子宫下段肌层折叠缝合联合宫腔镜治疗剖宫产术后子宫瘢痕憩室(CSD)的临床效果。方法选择2015年1月至2019年12月邯郸市中心医院收治的CSD患者26例,根据治疗方式不同分为观察组(采用宫腔镜子宫瘢痕憩室切除联合腹腔镜子宫下段肌层折叠缝合修复子宫下段肌层,14例)和对照组(采用宫腔镜引导下经腹腔镜切除子宫瘢痕后重新缝合修复子宫下段肌层,12例)。比较两组患者的手术时间、术中出血量、术后住院时间,以及术后子宫下段肌层的恢复情况。结果两组手术时间、术后住院时间比较差异无统计学意义(P> 0.05)。观察组术中出血量少于对照组,差异有统计学意义(P <0.01)。与术前比较,两组术后子宫下段肌层厚度均显著增厚(P <0.01),但两组间比较差异无统计学意义(P> 0.05)。结论腹腔镜子宫下段肌层折叠缝合联合宫腔镜治疗CSD疗效确切,且手术操作更简易,术中出血量更少,值得临床推广。更多还原

【Abstract】 Objective To observe the clinical effect of laparoscopic folding suture of the lower uterine segment combined with hysteroscopy on treatment of cesarean scar diverticulum( CSD). Methods Twenty-six CSD patients admitted to Handan Central Hospital from January 2015 to December 2019 were selected and divided into the observation group( receiving hysteroscopic scar diverticulectomy combined with laparoscopic folding suture of the myometrium of the lower uterine segment to repair the myometrium of the lower uterine segment,14 cases) and the control group( receiving laparoscopic excision of uterine scar and re-suturing to repair the myometrium of the lower uterine segment under the guidance of hysteroscope,12 cases) according to different treatment methods. The operation time,intraoperative blood loss,postoperative hospital stay,and postoperative recovery of the myometrium of the lower uterine segment were compared between the two groups. Results There was no significant difference in the operation time and postoperative hospital stay between the two groups( P > 0. 05). The intraoperative blood loss of the observation group was less than that of the control group,and the difference was statistically significant( P < 0. 01). Compared with that before operation,the thickness of the myometrium of the lower uterine segment increased significantly in the two groups after operation( P < 0. 01),but the difference was not statistically significant between the two groups( P > 0. 05).Conclusion Laparoscopic folding suture of the lower uterine segment combined with hysteroscopy has a definite curative effect on treatment of CSD,and the operation is simpler and the amount of intraoperative blood loss is less. It is worthy of clinical promotion.更多还原