子宫瘢痕憩室妇女宫腹腔镜下外科治疗效果研究

摘要

Objective To explore the effect of surgical treatment under hysteroscopy and laparoscopy on women with uterine scar diverticulum.Methods Altogether 200 patients who were diagnosed with uterine scar diverticulum after caesarean section and admitted in Jinan Maternal and Child Health Care Hospital from February 2014 to February 2016 were selected and randomly divided into study group and control group with 100 patients in each group.Patients in study group underwent surgery guided by hysteroscopy and laparoscopy,and patients in control group received transvaginal surgery.All patients were followed up for 12 months.Length of hospital stay,hospitalization cost,length of operation,intraoperative blood loss,anal exhaust time and recovery status were observed in two groups.Results Length of operation in study group was significantly longer than that in control group(t=3.916,P< 0.05),and intraoperative blood loss in study group was significantly greater than that in control group(t=3.801,P<0.05).Length of hospital stay in study group was significantly shorter than that in control group(t=4.406, P<0.05),but hospitalization cost increased significantly(t = 4.571, P < 0.05).There was no significant difference in postoperative anal exhaust time between two groups(t= 0.579,P> 0.05).Forty-six cases were recovered and 38 cases were effective in study group,whose total effective rate was 84.00%(84/100).Thirty-nine cases were recovered and 31 cases were effective in control group,whose total effective rate was 70.00%(70/100).Total effective rate in study group was significantly higher than that in control group(χ2= 5.534,P<0.05).Conclusion Surgical treatment under hysteroscopy and laparoscopy has good effect on women with uterine scar diverticulum.It can be used to treat patients with moderate or severe uterine scar diverticulum.%目的 探讨子宫瘢痕憩室妇女宫、腹腔镜下的外科治疗效果.方法 选取济南市妇幼保健院于2014年2月至2016年2月收治的200例经剖宫产术后诊断为子宫瘢痕憩室患者,随机分为研究组和对照组,每组各100例.研究组患者接受宫、腹腔镜下手术治疗,对照组患者接受阴式手术治疗.术后跟踪随访12个月,观察两组患者的住院时间、住院费用、手术时长、手术中出血量、肛门排气时间以及恢复情况.结果 研究组手术时间显著长于对照组(t=3.916,P<0.05)、手术中出血量显著多于对照组(t=3.801,P<0.05).研究组住院时间较对照组显著缩短(t=4.406,P<0.05),而住院费用较对照组显著增加(t=4.571,P<0.05),两组患者术后肛门排气时间无显著性差异(t=0.579,P>0.05).研究组痊愈46例,有效38例,总有效率为84.00%(84/100),对照组痊愈39例,有效31例,总有效率为70.00%(70/100),研究组总有效率显著高于对照组(χ2=5.534,P<0.05).结论 子宫瘢痕憩室妇女采用宫、腹腔镜的外科治疗方式效果较好,对于有明显临床表现的中重度子宫瘢痕憩室患者可考虑此方法治疗.