摘要
目的探讨宫腹腔镜联合下子宫切口憩室(PCSD)切除及子宫修补术治疗PCSD患者临床价值,为术式选择提供一定参考。方法分析2018-10-01-2020-01-01内黄县人民医院82例PCSD患者临床资料,将采用宫腹腔镜联合下PCSD切除及子宫修补术治疗的42例为观察组,同期采用经阴道子宫切口憩室修补术治疗的40例为对照组。统计2组手术情况、月经改善情况、手术前PCSD后憩室深度与宽度、术后12个月妊娠率、复发率;术前、术后1 d、3 d以放射免疫法检测应激反应指标β-内啡肽(β-EP)、去甲肾上腺素(NE)、皮质醇(Cor)水平。应用SPSS 21.0统计学软件对数据进行统计学处理。结果与对照组相比,观察组术中出血量[(74.59±13.58)mL]降低,手术时间[(73.58±12.06)min]延长,住院时间[(5.17±1.84)d]、术后阴道出血时间[(7.73±0.71)d]缩短(t分别为8.924、6.282、6.973、10.610,均P<0.05);2组月经改善情况差异无统计学意义,χ^(2)=0.005,P=0.946;术后2组憩室深度与宽度低于术前,但组间比较差异无统计学意义,P>0.05;2组术后12个月妊娠率、复发率差异无统计学意义,P>0.05。结论宫腹腔镜联合下PCSD切除及子宫修补术治疗PCSD效果确切,且可有效降低术中创伤程度,缩短术后阴道流血时间,促进术后恢复,应用价值高。
Objective The clinical value of laparoscopy combined with uterine incision diverticulectomy and uterine repair in the treatment of patients with uterine incision diverticulum(PCSD)was explored from various aspects,so as to provide a certain reference for surgical selection.Methods The clinical data of 82 patients with PCSD in Neihuang County People’s Hospital from October 1,2018 to January 1,2020 were analyzed.Forty-two patients were treated with laparoscopy combined with uterine incision diverticectomy and uterine repair as the observation group,and 40 patients were treated with vaginal uterine incision diverticular repair as the control group.The operation situation,improvement of menstruation,the depth and width of diverticulum before and after surgery,pregnancy rate and recurrence rate at 12 months after surgery were analyzed.Stress response indexes[β-endorphin(β-EP),norepinephrine(NE),cortisol(Cor)]were detected by radioimmunoassay before operation,1 d after operation and 3 d after operation.SPSS 21.0 statistical software was used for statistical processing.Results Compared with the control group,the intraoperative blood loss in the observation group[(74.59±13.58)ml]was lower,and the operative time[(73.58±12.06)min]was longer the length of hospital stay[(5.17±1.84)d],and the duration of postoperative vaginal bleeding[(7.73±0.71)d]were shortened(t were 8.924,6.282,6.973,10.610,all P<0.05).There was no significant difference in menstrual improvement between the two groups(χ^(2)=0.005,P=0.946).The depth and width of diverticulum in the two groups after surgery were lower than that before surgery,but there was no significant difference between the two groups(P>0.05).There was no significant difference in pregnancy rate and recurrence rate 12 months after operation between the two groups(P>0.05).Conclusion Uterine laparoscopy combined with uterine incision diverticectomy and uterine repair in the treatment of PCSD has an accurate effect,and can effectively reduce the degree of intraoperative trauma,shorten the postoperative vaginal bleeding time,promote postoperative recovery,and has high application value.
作者
李玉霞
何运姣
LI Yu-xia;HE Yun-jiao(Department of Obstetrics and Gynecology of Neihuang County People's Hospital,Anyang 456300,China)
出处
《社区医学杂志》
CAS
2021年第22期1358-1361,共4页
Journal Of Community Medicine
关键词
宫腹腔镜
子宫切口憩室切除
子宫修补术
子宫切口憩室
创伤程度
uterine laparoscopy
uterine incision diverticulum resection
uterine repair
uterine incision diverticulum
the degree of trauma
作者简介
通信作者:李玉霞,女,河南内黄人,副主任医师,主要从事妇产科学的临床研究工作。E-mail:kargln@163.com
