CAJ | 학술논문

目的：探讨经阴道剖宫产术后子宫切口憩室（CSD）修补手术的临床疗效。方法对同济大学附属第一妇婴保健院2013年3月至2014年9月期间接受经阴道CSD修补手术的64例患者的临床病理资料进行回顾性分析和术后随访。结果64例CSD患者剖宫产术后均存在月经淋漓不净，平均经期为（14.8±3.5）d；均实施了经阴道CSD修补手术，无手术并发症发生，手术均顺利完成，平均手术时间（67±12）min，平均术中出血量（53±32）ml，平均住院时间（4.0±1.1）d。64例患者均术后随访，经阴道CSD修补手术后经期较术前平均缩短（8.1±3.5）d，差异有统计学意义（P<0.01）；症状学评估手术有效率为94%（60/64），解剖学评估手术有效率为95%（61/64）；手术前后憩室部位距离子宫浆膜层厚度均有明显改善，术后较术前平均增厚了（3.4±0.4）mm，差异有统计学意义（P<0.01）。结论经阴道CSD修补手术具有手术微创，暴露清楚，修补疗效确切，住院时间短等优点，值得临床推广。
목적：탐토경음도부궁산술후자궁절구게실（CSD）수보수술적림상료효。방법대동제대학부속제일부영보건원2013년3월지2014년9월기간접수경음도CSD수보수술적64례환자적림상병리자료진행회고성분석화술후수방。결과64례CSD환자부궁산술후균존재월경림리불정，평균경기위（14.8±3.5）d；균실시료경음도CSD수보수술，무수술병발증발생，수술균순리완성，평균수술시간（67±12）min，평균술중출혈량（53±32）ml，평균주원시간（4.0±1.1）d。64례환자균술후수방，경음도CSD수보수술후경기교술전평균축단（8.1±3.5）d，차이유통계학의의（P<0.01）；증상학평고수술유효솔위94%（60/64），해부학평고수술유효솔위95%（61/64）；수술전후게실부위거리자궁장막층후도균유명현개선，술후교술전평균증후료（3.4±0.4）mm，차이유통계학의의（P<0.01）。결론경음도CSD수보수술구유수술미창，폭로청초，수보료효학절，주원시간단등우점，치득림상추엄。
Objective To explore the clinical effect of transvaginal repair of cesarean scar diverticulum (CSD). Methods Totally 64 patients of CSD in the First Maternity and Infant Hospital, Tongji University between Mar. 2013 and Sept. 2014 underwent transvaginal repair of CSD were reviewed retrospectively and followed. Result All the patients had a prolonged period, and the duration was (14.8± 3.5) days; all the patients were received the transvaginal repair of CSD, there was no intra-operative complications, the procedures were successfully performed in all patients. The mean operation time was (67± 12) minutes, the mean blood loss was (53±32) ml, and the mean length of hospital stay was (4.0±1.1) days. All patients were followed after the operation, the duration of menstruation was (8.1 ± 3.5) days shorter in average, which was statistically significant (P<0.01);the operation effective rate was 94%(60/64) to assess the clinic syptoms, the operation effective rate was 95%(61/64) for anatomic assessment. The distance of the CSD from the serosa became thicker after surgery significantly, the distance was thicker (3.4 ± 0.4) mm compared with preoperation (P<0.01). Conclusions Transvaginal repair of CSD offers minimal invasiveness, good exposure and accurate resection. It is worth to be popularized in the treatment of patients with CSD.