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宫腔镜和腹腔镜下憩室切除术缝合术对出血量、手术时间和抗生素时间的影响。

The effects of hysteroscopy and laparoscopy for scar diverticulum resection and suture on blood loss, operation time and antibiotic time.

机构信息

Department of Obstetrics and Gynecology, The First People's Hospital of Foshan, Foshan, China.

出版信息

J Obstet Gynaecol. 2022 Oct;42(7):3309-3314. doi: 10.1080/01443615.2022.2122708. Epub 2022 Oct 6.

Abstract

To evaluate the effect of hysteroscopy and suture on uterine scar diverticulum (CSD) after caesarean section and its influence on blood loss, operation time and antibiotic time. Eighty-nine patients with CSD were divided into observation group ( = 41 cases) and control group ( = 48 cases). Control group received laparoscopic scar diverticulum resection and suture, while the observation group received hysteroscopic resection of scar diverticulum. The operation time of the observation group was longer, while the bleeding volume and antibiotic administration time were significantly lower. The surgical treatment efficiency of the observation group (97.56%) was significantly higher. After treatment, the observation group's diverticulum repair indexes (width, depth and lower uterine muscular layer thickness) were better than those of the control group (<.05). Hysteroscopic resection of scar diverticulum in CSD reduces intraoperative blood loss and the risk of complications, shortens time of antibiotic administration, and promotes diverticulum repair.Impact Statement Uterine scar diverticulum (CSD) after caesarean section, also called postoperative uterine incision defect (PCSD), is due to poor healing of the uterine incision after caesarean section. Hysteroscopic resection of scar diverticulum in CSD has a significant clinical effect, which can effectively reduce intraoperative blood loss and the risk of complications, shorten the time of antibiotic administration, and promote diverticulum repair. Clinical effect of hysteroscopic resection of scar diverticulum in CSD is significant.

摘要

评估宫腔镜和缝合术对剖宫产术后子宫瘢痕憩室(CSD)的影响及其对出血量、手术时间和抗生素时间的影响。将 89 例 CSD 患者分为观察组(n=41)和对照组(n=48)。对照组接受腹腔镜瘢痕憩室切除术和缝合术,观察组接受宫腔镜瘢痕憩室切除术。观察组的手术时间较长,但出血量和抗生素使用时间明显较低。观察组的手术治疗效率(97.56%)明显更高。治疗后,观察组的憩室修复指标(宽度、深度和子宫下段肌层厚度)均优于对照组(<.05)。宫腔镜切除 CSD 中的瘢痕憩室可减少术中出血量和并发症风险,缩短抗生素使用时间,并促进憩室修复。

子宫瘢痕憩室(CSD)是剖宫产术后的一种并发症,也称为剖宫产术后子宫切口缺陷(PCSD),是由于剖宫产术后子宫切口愈合不良所致。宫腔镜切除 CSD 中的瘢痕憩室具有显著的临床效果,可有效减少术中出血量和并发症风险,缩短抗生素使用时间,并促进憩室修复。宫腔镜切除 CSD 中的瘢痕憩室的临床效果显著。

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