双镜联合憩室修补重建术治疗剖宫产子宫切口憩室的临床研究OA
Clinical study of hysteroscopic combined with laparoscopic repair and reconstruction of diverticulum in the treatment of post-cesarean section uterine diverticulum
目的 观察双镜联合憩室修补重建术治疗剖宫产子宫切口憩室(PCSD)的临床效果.方法 选取2020年1月至2022年2月我院妇产科收治的PCSD患者150例,根据手术方案不同分为经阴道组(经阴道憩室修补术)和双镜组(双镜联合憩室修补重建术),每组75例.记录2组患者手术一般情况、月经期天数、肌层厚度、炎症相关因子水平、并发症及有生育计划患者妊娠情况.结果 双镜组患者手术时间长于经阴道组,肛门排气时间、术后住院时间均短于经阴道组,差异有统计学意义(P<0.05);2组患者术中出血量比较,差异无统计学意义(P>0.05).2组患者术后7 d的高敏C反应蛋白(hs-CRP)、白细胞介素-4(IL-4)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平均较术前降低,且双镜组低于经阴道组,差异均有统计学意义(P<0.05).与术前相比,2组患者术后6、12个月的月经期天数减少,肌层厚度增加,差异均有统计学意义(P<0.05);2组患者术后6、12个月的月经期天数、肌层厚度比较,差异均无统计学意义(P>0.05).2组患者切口感染、低钠血症、膀胱损伤、阴道感染等累计并发症发生率比较,差异无统计学意义(P>0.05).双镜组有生育计划患者宫内妊娠率、足月妊娠率均高于经阴道组,差异有统计学意义(P<0.05).2组患者流产率和早产率比较,差异无统计学意义(P>0.05).结论 双镜联合憩室修补重建术治疗PCSD患者术后恢复快,住院周期短,可提高有生育计划患者妊娠率.
Objective To observe the clinical effect of hysteroscopic combined with laparoscopic repair and reconstruction of diverticulum in the treatment of post-cesarean section uterine diverticulum(PCSD).Methods A total of 150 patients with PCSD admitted to the department of gynaecology of our hospital from January 2020 to February 2022 were selected and divided into the transvaginal group(transvaginal repair of diverticulum)and the combined group(hysteroscopic combined with laparoscopic repair and reconstruction of diverticulum)according to different surgical plans,with 75 cases in each group.The general condition of surgery,days of menstrual period,thickness of muscular layer,inflammation-related factor levels,complications and pregnancy in patients with birth plan were recorded in both groups.Results The operation time of patients in the combined group was longer than that in the transvaginal group,and the time of anal exhaustion and postoperative hospital stay of patients in the combined group were shorter than those in the transvaginal group,the differences were statistically significant(P<0.05);There was no significant difference in terms of the intraoperative bleeding volume of patients between the two groups(P>0.05).The high-sensitivity C-reactive protein(hs-CRP),interleukin-4(IL-4),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)7 days after surgery of patients were lower in both groups compared with those before surgery,and the combined group was lower than the transvaginal group,the differences were statistically significant(P<0.05).Compared with that before the surgery,the days of menstrual period of patietns in both groups 6 and 12 months after the surgery decreased,and the thickness of muscular layer increased,with statistically significant differences(P<0.05);while no statistically significant difference was found in terms of the days of menstrual period or thickness of muscular layer of patients 6 and 12 months after surgery between the two groups(P>0.05).There was no significant difference in the incidence of cumulative complications such as incision infection,hyponatraemia,bladder injury and vaginal infection between the two groups(P>0.05).The intrauterine pregnancy rate of patients with birth plan and the full-term pregnancy rate in the combined group were higher than those in the transvaginal group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the abortion rate or preterm birth rate between the two groups(P>0.05).Conclusion The hysteroscopic combined with laparoscopic repair and reconstruction of diverticulum for patients with PCSD has a fast postoperative recovery,a short hospital stay,and can increase the pregnancy rate of patients with birth plan.
王红;程佳;黄志琴;南方
鄂州市中心医院妇科,湖北 鄂州 436000鄂州市中心医院妇科,湖北 鄂州 436000鄂州市中心医院妇科,湖北 鄂州 436000鄂州市中心医院妇科,湖北 鄂州 436000
临床医学
双镜联合憩室修补重建术经阴道切口憩室修补术妊娠剖宫产子宫切口憩室并发症
hysteroscopic combined with laparoscopic repair and reconstruction of diverticulumtransvaginal repair of diverticulumpregnancypost-cesarean section uterine diverticulumcomplications
《局解手术学杂志》 2025 (6)
501-505,5
2023年度鄂州市科技计划项目(EZ01-007-20230058)
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