陈良湾 吴媚燕 曾勇先 陈建英 黄桂蓉

【摘要】 目的：探討子宫切口憩室采用阴式手术及宫腔镜手术治疗的效果。方法：选择2018年1月-2019年10月于本院经阴道超声联合宫腔镜检查确诊为剖宫产术后子宫切口憩室的58例患者为研究对象。根据手术方式的不同分为对照组（n=30）和研究组（n=28），对照组实施宫腔镜手术治疗，观察组实施阴式手术治疗。比较两组治疗效果、手术时间、术中出血量、术后住院时间、住院总费用、经期减少时间、手术前后经期与切口憩室深度;比较两组并发症发生、复发情况。结果：观察组总有效率、手术时间、术中出血量、术后住院时间及经期减少时间与对照组比较，差异均无统计学意义（P>0.05）;观察组住院总费用低于对照组，差异有统计学意义（P<0.05）。结论：剖宫产术后子宫切口憩室采用宫腔镜手术与阴式手术治疗均有较好的效果，但阴式手术治疗费用相对较低且治疗方式简便，具有较好的应用价值，在治疗时应该根据患者的具体情况选择合适的治疗方式。

【关键词】 子宫切口憩室 阴式手术 宫腔镜手术

Study on the Effect of Vaginal Surgery and Hysteroscopic Surgery in the Treatment of Uterine Incision Diverticulum/CHEN Liangwan， WU Meiyan， ZENG Yongxian， CHEN Jianying， HUANG Guirong. //Medical Innovation of China， 2021， 18（10）： 0-045

[Abstract] Objective： To explore the effect of vaginal surgery and hysteroscopy surgery in the diverticulum of uterus incision. Method： A total of 58 patients diagnosed with uterine incision diverticulum after cesarean section by transvaginal ultrasound combined with hysteroscopy in our hospital from January 2018 to October 2019 were selected as the research subjects. According to the different surgical methods， they were divided into control group （n=30） and study group （n=28）. The control group received hysteroscopic surgery， and the observation group received vaginal surgery. The treatment effect， operative time， intraoperative blood loss， postoperative hospitalization time， total hospitalization cost， period reduction time， menstrual period before and after surgery and incision diverticulum depth were compared between the two groups. The incidence and recurrence of complications were compared between the two groups. Result： There were no significant differences in total effective rate， operative time， intraoperative blood loss， postoperative hospital stay and menstrual reduction time between the observation group and the control group （P>0.05）. The total hospitalization cost of the observation group was lower than that of the control group， the difference was statistically significant （P<0.05）. Conclusion： Hysteroscopic surgery and vaginal surgery are effective in the treatment of uterine incision diverticulum after cesarean section， but the cost of vaginal surgery is relatively low and the treatment method is simple， which has good application value. The appropriate treatment method should be selected according to the specific situation of patients.

[Key words] Uterine incision diverticulum Vaginal surgery Hysteroscopic surgery

First-authors address： Yangjiang Maternal and Child Health Hospital， Yangjiang 529500， China

doi：10.3969/j.issn.1674-4985.2021.10.010

随着剖宫产率的升高，剖宫产术后子宫切口憩室的发病率也越来越高，该病会延长患者经期，导致其在经期内阴道流血淋漓不尽，患者会伴随瘢痕子宫症状，对其身心健康与家庭和谐均有严重影响[1-3]。随着二胎政策的开放，子宫切口憩室引发的矛盾日趋尖锐，需要引起高度重视并及时采取有效治疗。临床一般采用手术方式治疗子宫切口憩室，宫腔镜手术与阴式手术均为有效的治疗方式，通过治疗可改善患者临床症状，提高其生活质量[4-6]。本次研究对子宫切口憩室采用阴式手术及宫腔镜手术治疗，现报道如下。

1 资料与方法

1.1 一般资料 选择2018年1月-2019年10月于本院经阴道超声联合宫腔镜检查确诊为剖宫产术后子宫切口憩室的58例患者为研究对象。纳入……