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目的:探讨剖宫产术后子宫瘢痕憩室应用宫、腹腔镜联合手术治疗的临床效果。方法:选择经彩色多普勒超声诊断子宫瘢痕憩室,有手术指征的患者17例,在全麻下进行宫、腹腔镜联合手术,分离子宫膀胱反折腹膜,切除憩室病灶,重新缝合子宫肌层。结果:17例患者手术顺利,平均手术时间为69.2±28.7(35~110)min,术后临床症状消失,6个月后复查超声肌层连续,肌壁厚度为1.35±0.28(0.8~1.8)cm,与术前的肌壁厚度0.33±0.10(0.17~0.5)cm相比,差异有统计学意义(P<0.05)。结论:宫、腹腔镜联合手术治疗剖宫产术后子宫瘢痕憩室安全,微创,效果确切。
Objective: To investigate the clinical effect of hysterectomy and uterine scar diverticulum combined with laparoscopy and surgery. Methods: Seventeen patients with surgical indications who were diagnosed by color Doppler ultrasonography were enrolled in this study. Under general anesthesia, the patients underwent combined laparoscopic surgery and hysteroscopic surgery to separate the peritoneum of the uterine bladder, cut off the diverticula lesions and resect the uterine muscles Floor. Results: The operation was successful in 17 patients. The mean operative time was 69.2 ± 28.7 (35 ~ 110) min. The clinical symptoms disappeared. The myometrium was found to be continuous after 6 months. The thickness of muscular wall was 1.35 ± 0.28 (0.8 ~ 1.8) cm, compared with the preoperative muscle wall thickness of 0.33 ± 0.10 (0.17 ~ 0.5) cm, the difference was statistically significant (P <0.05). Conclusion: The combination of hysteroscope and laparoscopy in the treatment of uterine scar diverticulum after cesarean section is safe, minimally invasive and effective.