摘要
目的探讨经阴道子宫憩室修补术治疗剖宫产后子宫切口憩室的临床效果。方法选择2013年12月至2016年12月驻马店市第一人民医院收治的62例子宫切口憩室患者为研究对象,根据治疗方法分为观察组和对照组,每组31例。对照组患者给予开腹憩室修补术,观察组患者给予经阴道子宫憩室修补术。记录2组患者手术时间、术后肛门排气时间、住院时间、阴道出血时间;分别于手术前后使用Acuson X300型彩色多普勒超声诊断仪测量憩室深度及宽度;术后6个月评定2组患者疗效;术后随访1 a,观察憩室复发和术后并发症发生情况。结果观察组患者手术时间、术后肛门排气时间、住院时间、阴道出血时间短于对照组(P <0. 05)。2组患者手术前憩室深度、宽度比较差异无统计学意义(P> 0. 05),2组患者手术后憩室深度及宽度均显著小于手术前(P <0. 05);手术后,观察组患者憩室深度及宽度显著小于对照组(P <0. 05)。观察组和对照组患者术后总有效率分别为96. 77%(30/31)、74. 19%(23/31),观察组患者治疗总有效率高于对照组(χ2=4. 369,P <0. 05)。观察组和对照组患者术后并发症发生率分别为3. 23%(1/31)、22. 58%(7/31),观察组患者术后并发症发生率低于对照组(χ2=6. 177,P <0. 05)。观察组和对照组患者术后1 a憩室复发率分别为3. 23%(1/31)、16. 13%(5/31),观察组患者术后1 a憩室复发率低于对照组(χ2=5. 638,P <0. 05)。结论经阴道子宫切口憩室修补术治疗子宫切口憩室可以更彻底地清除病灶,缩短手术时间,减少术中出血量,促进患者术后恢复,降低术后并发症发生率和憩室复发率。
Objective To investigate the clinical effect of transvaginal uterine diverticulum neoplasty in the treatment of uterine incision diverticulum after uterine-incision delivery.Methods A total of 62 patients with uterine incision diverticulum after uterine-incision delivery in the First People′s Hospital of Zhumadian City from December 2013 to December 2016 were selected as the subjects.The patients were divided into observation group and control group according to the treatment method,31 cases in each group.The patients in the control group were treated with transabdominal diverticulum neoplasty,while the patients in the observation group were treated with transvaginal uterine diverticulum neoplasty.The operation time,postoperative anal exhaust time,hospitalization time and vaginal bleeding time of patients in the two groups were recorded.The depth and width of diverticulum were measured by Acuson X300 color Doppler diasonography before and after operation.The curative effect of patients in the two groups was evaluated at 6 months after operation.All patients were followed up for one year after operation to observe the recurrence of diverticulum and the occurrence of complications.Results The operation time,postoperative anal exhaust time,hospitalization time and vaginal bleeding time in the observation group were shorter than those in the control group(P<0.05).There was no significant difference in the depth and width of diverticulum between the two groups before operation(P>0.05).The depth and width of diverticulum after operation were significantly lower than those before operation in the two groups(P<0.05).The depth and width of diverticulum in the observation group were significantly less than those in the control group after operation(P<0.05).The total effective rate in the observation group and control group was 96.77%(30/31)and 74.19%(23/31),respectively.The total effective rate in the observation group was higher than that in the control group(χ^2=4.369,P<0.05).The incidence of complications in the observation group and control group was 3.23%(1/31)and 22.58%(7/31),respectively.The incidence of complications in the observation group was lower than that in the control group(χ^2=6.177,P<0.05).The recurrence rate of diverticulum at one year after-operation in the observation group and control group was 3.23%(1/31)and 16.13%(5/31),respectively.The recurrence rate of diverticulum at one year after-operation in the observation group was lower than that in the control group(χ^2=5.638,P<0.05).Conclusion Transvaginal uterine incision diverticulum neoplasty for uterine incision diverticulum can more thoroughly remove the focus,shorten the operation time,reduce intraoperative bleeding,promote the postoperative recovery of patients,reduce the incidence of postoperative complications and the recurrence rate of diverticulum.
作者
徐剀
XU Kai(Department of Obstetrics and Gynaecology,the First People′s Hospital of Zhumadian City,Zhumadian 463000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第2期136-138,142,共4页
Journal of Xinxiang Medical University
关键词
阴道
子宫切口憩室
修补术
瘢痕
剖宫产
vagina
uterine incision diverticulum
neoplasty
scar
uterine-incision delivery