3种剖宫产切口疤痕憩室修补术疗效比较分析

发布时间：2018-04-06 02:34

本文选题：剖宫产切口疤痕憩室　切入点：剖宫产切口疤痕缺陷　出处：《暨南大学学报(自然科学与医学版)》2015年04期

【摘要】：目的:评价3种路径的剖宫产切口疤痕憩室修补术的主、客观疗效及安全性.方法:选取诊断明确、有生育要求或疤痕憩室顶端肌层厚度2 mm、有症状的剖宫产切口疤痕憩室(CSD)患者26例,行疤痕憩室修补术,根据术后月经期有无缩短及症状是否消失评价其主观疗效,根据术后超声检查憩室是否消失评价其客观疗效.结果:26例患者其中6例行腹腔镜修补术,8例开腹修补术,12例经阴道修补术,随访(12.6±6.3)月,其中治愈12例,好转6例,无效8例(均为经阴道手术);主观有效率为69.2%(18/26);术后月经期(9.5±4.0)d较术前(12.6±4.1)d明显缩短(P0.001).术后复查阴道B超,16例憩室消失,客观治愈率为61.5%,无手术并发症.结论:疤痕憩室修补术是治疗CSD的有效、安全的术式,适合有生育要求且憩室顶端肌层较薄的患者.
[Abstract]:Objective: to evaluate the efficacy and safety of scar diverticulum repair in caesarean incision.Methods: 26 patients with clear diagnosis, 2 mm thickness of muscle layer at the top of scar diverticulum or 2 mm thickness of muscle layer at the top of scar diverticulum with symptomatic cesarean section incision scar diverticulum (CSD) were treated with scar diverticulum repair.The subjective curative effect was evaluated according to whether the menstrual period was shortened and the symptoms disappeared, and the objective curative effect was evaluated according to the postoperative ultrasonic examination whether the diverticulum disappeared or not.Results among 26 cases, 6 cases underwent laparoscopic repair and 8 cases underwent laparotomy. 12 cases were followed up for 12.6 卤6.3 months. 12 cases were cured and 6 cases improved.The subjective effective rate was 69.2% / 26%, and the menstrual period was 9.5 卤4.0 days after operation, which was significantly shorter than that before operation (12.6 卤4.1 days).After operation, 16 cases of vaginal diverticulum disappeared, and the objective cure rate was 61.5%.Conclusion: scar diverticulum repair is an effective and safe procedure for the treatment of CSD. It is suitable for patients with fertility requirement and thin muscle layer at the apex of the diverticulum.
【作者单位】：广州市妇女儿童医疗中心妇产科;
【基金】：广东省人口计生委基金项目(20110262)
【分类号】：R713.4

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