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目的探究经宫腹腔镜联合手术切除对剖宫产术后子宫切口瘢痕憩室的疗效。方法选取该院2014年2月-2016年2月收治的68例剖宫产术后子宫切口瘢痕憩室患者为研究对象,采用随机数字表法将其分为观察组和对照组各34例,观察组采用经宫腹腔镜联合手术切除治疗,对照组阴道手术治疗,比较两组患者手术时间、术中出血量、住院时间,统计并比较两组患者术后最高体温、肛门排气时间、术后阴道出血时间,随访3个月,观察两组患者随访期间月经改善情况以及B超下憩室修复情况以及并发症情况。结果对照组手术时间较观察组明显缩短,差异有统计学意义(t=8.209,P<0.05),且术中出血量较观察组显著减少,差异有统计学意义(t=3.978,P<0.05),但观察组住院时间较对照组明显缩短,差异有统计学意义(t=12.697,P<0.05);两组患者术后最高体温比较差异无统计学意义(t=0.856,P>0.05),但观察组肛门排气时间、术后阴道出血时间较对照组均显著缩短,差异有统计学意义(t=7.453、8.340,均P<0.05);两组患者临床疗效及并发症比较差异无统计学意义(χ~2=0.183、0.325,均P>0.05)。结论经宫腹腔镜联合手术切除治疗剖宫产后子宫切口瘢痕憩室术后恢复较快,疗效显著,但术中出血量多,手术风险大,临床上应根据患者实际情况结合患者意愿选择合适的手术进行治疗。
Objective To investigate the efficacy of transcervical laparoscopic surgery combined with surgical resection of scar incision diverticulum after cesarean section. Methods A total of 68 patients with scar-diverticular hysterectomy after cesarean section were selected from February 2014 to February 2016 in our hospital. Patients were divided into observation group and control group with random number table method. The patients underwent laparoscopic hysterectomy combined with vaginal surgery. The control group received vaginal surgery. The operation time, intraoperative blood loss and hospitalization time were compared between the two groups. The postoperative maximal body temperature, anal exhaust time, Vaginal bleeding time, followed up for 3 months to observe the improvement of menstruation during the follow-up period of both groups and B-diverticulum repair situation and complications. Results The operation time of the control group was significantly shorter than that of the observation group (t = 8.809, P <0.05), and the amount of bleeding during operation was significantly lower than that of the observation group (t = 3.978, P <0.05 ), But the length of stay in the observation group was significantly shorter than that in the control group (t = 12.697, P <0.05). There was no significant difference in postoperative maximum body temperature between the two groups (t = 0.856, P> 0.05) , But the observation group anal exhaust time, postoperative vaginal bleeding time were significantly shorter than the control group, the difference was statistically significant (t = 7.453,8.340, both P <0.05); two groups of patients with clinical efficacy and complications were no difference Statistical significance (χ ~ 2 = 0.183,0.325, all P> 0.05). Conclusions The hysteroscopic laparoscopic resection of cesarean scar after hysterectomy for postoperative recovery of scar scar diverticulum, the effect was significant, but the amount of intraoperative bleeding, the risk of surgery, clinical should be based on the actual situation of patients with the wishes of patients to choose the appropriate Surgical treatment.