CAJ | 학술논문

目的：对比不同术式治疗剖宫产子宫切口憩室（PCSD）的再次妊娠结局。方法PCSD 患者150例，随机分为3组，阴式手术组48例，经阴道行子宫切口憩室切除术；宫腔镜手术组49例，宫腔镜下行子宫切口憩室切除术；腹式手术组53例，行传统的开腹子宫切口憩室切除术。随访2年，比较3组患者再次妊娠的结局。结果阴式手术组宫内妊娠率最高（P ＜0．05），宫腔镜手术组与腹式手术组的宫内妊娠率比较，差异无统计学意义（P ＞0．05）。3组瘢痕妊娠、憩室妊娠、继发不孕发生率比较，差异无统计学意义（P ＞0．05）。结论阴式手术治疗子宫切口憩室对再次妊娠的影响小于宫腔镜手术治疗和开腹手术治疗，值得临床应用与推广。
목적：대비불동술식치료부궁산자궁절구게실（PCSD）적재차임신결국。방법PCSD 환자150례，수궤분위3조，음식수술조48례，경음도행자궁절구게실절제술；궁강경수술조49례，궁강경하행자궁절구게실절제술；복식수술조53례，행전통적개복자궁절구게실절제술。수방2년，비교3조환자재차임신적결국。결과음식수술조궁내임신솔최고（P ＜0．05），궁강경수술조여복식수술조적궁내임신솔비교，차이무통계학의의（P ＞0．05）。3조반흔임신、게실임신、계발불잉발생솔비교，차이무통계학의의（P ＞0．05）。결론음식수술치료자궁절구게실대재차임신적영향소우궁강경수술치료화개복수술치료，치득림상응용여추엄。
Objective To compare the secondary pregnancy outcomes of previous cesarean scar defect(PCSD) patients undergoing cesarean section with different surgical procedures.Methods One hundred and fifty patients with PCSD were randomly divided into three groups,48 cases in the vaginal operation group were given transvaginal resection for PCSD,49 cases in the hysteroscopy group were given hysteroscopic resection for PCSD,and 53 cases in the abdominal operation group were given traditional abdominal resection for PCSD.The patients were followed up for 2 years.The secondary pregnancy outcomes of the patients in three groups were compared.Results The incidence of intrauterine pregnancy was the highest in the vaginal operation group(P <0.05).There was no significant difference in the incidence of intrauterine pregnancy between hysteroscopy group and abdominal operation group(P >0.05).There was no significant difference in the incidence of scar pregnancy,diverticulum pregnancy or secondary infertility among three groups(P >0.05).Conclusion Vaginal operation has less impact on secondary pregnancy outcome of PCSD patients compared with hysteroscopic resection and abdominal resection.It is worthy of application and popularization in clinical practice.