阴道超声联合两种不同手术方式诊治剖宫产术后子宫切口憩室53例疗效分析

摘要

Objective To investigate the feasibility and effectiveness of two operation methods combined with transvaginal ultrasonogra-phy treating previous cesarean scar defect(PCSD).Methods We selected 53 clinical data examples of PCSD patients and assigned them into group A(n =27)and group B(n =26).Group A underwent vaginal operation,while group B underwent hysteroscopic opera-tion.The clinical indexes and monitored treatment effects were compared between the two groups.Results There were two cases (3.8%)of complications.There were no significant differences in blood loss,hospital stay and anal exhaustion time between group A and B(P >0.05),yet there was significant difference in operation time between the two groups(P <0.05).As for efficacy evaluation, In group A,21 patients were cured and 5 patients became better.The effective rate was 96.30%(26 /27).In group B,15 patients were cured and 4 patients became better.The effective rate was 73.10% (19 /26).The total effective rate of both group A and B was 84.90%.Of all 53 cases the coincidence rate of vaginal ultrasound diagnosis of disease with surgical and potholgical diagnosis was 100%.Conclusions The two methods both can improve the symptoms of PCSD,however,transvaginal surgery is recommended as the preferred method.It is simple,safe and more effective,which is worthy of promotion.%目的：探讨阴道超声联合两种不同手术方式诊治剖宫产术后子宫切口憩室（PCSD）的可行性和有效性。方法选择PCSD 患者53例的临床资料，其中 A 组27例患者行经阴道手术，B 组26例患者采用宫腔镜手术，比较两组围手术期临床指标，随访治疗效果。结果53例患者手术有2例并发症发生，并发症发生率为3．8％；A 组术中出血量、住院时间、肛门排气时间与 B 组比较差异无统计学意义（P ＞0．05），A 组手术时间与 B 组比较差异有统计学意义（P ＜0．05）；疗效评估：A 组治愈21例，好转5例，有效率96．30％（26／27）；B 组治愈15例，好转4例，有效率73．10％（19／26），两组总有效率为84．90％。53例阴道超声诊断病例与手术及病理诊断符合率为100％。结论阴道超声可推荐作为 PCSD 首选诊断方法；两种手术方式均能一定程度改善 PCSD 的症状，但阴式手术效果更显著，是一种简单，安全，有效的治疗方法，值得推广使用。