| 摘要: |
| ［摘要］ 目的 探讨宫腹腔镜及宫腔镜在剖宫产术后子宫切口憩室诊治中的作用及疗效．方法 回顾性分析2010年1月至2014年10月云南省第二人民医院收治的21例剖宫产术后子宫切口憩室的患者，全部行宫腔镜检查，12例无生育要求患者采用宫腔镜电切整形治疗，9例有生育要求患者采用宫腹腔镜联合手术修补治疗．结果 21例患者均在宫腔镜下得到确诊，采用宫腔镜电切整形治疗的12例患者，手术时间 25～45 min，平均（35±10） min，术中出血量为2～10 mL，平均（6±4）mL．采用宫腹腔镜联合手术修补治疗的9例患者，手术时间90～165 min，平均为（127.5±37.5）min，术中出血量为30～80 mL，平均（55±25）mL．术后随访6月，21例患者术后1月经期均恢复正常，半年内均在正常范围，术后6月随访时单纯宫腔镜治疗患者3例复发，宫腹腔镜联合治疗的患者均无复发．结论 宫腔镜检查有望成为检查子宫切口憩室的金标准，2种手术短期内均可以有效缓解症状，且各有优点，宫腔镜电切整形操作简便、手术时间短，术中出血少，宫腹腔镜联合手术修补，疗效确切，复发率低，2种方法在临床上均值得推广，但远期疗效尚有待进一步观察． |
| 关键词: ［关键词］ 剖宫产术后子宫切口憩室 宫腔镜 腹腔镜 |
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| The Analysis of Hysteroscopy and Laparoscopy in Diagnosis and Treatment of Previous Cesarean Scar Defect in 21 Cases |
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YUAN Ying
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（Dept. of Gynaecology，The Second People's Hospital of Yunnan Province，Kunming Yunnan 650021，China）
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| Abstract: |
| ［Abstract］Objective To investigate the effect of hysteroscopy and laparoscopy in the diagnosis and treatment of previous cesarean scar defect．Methods We retrospectively analyzed the data of 21 patients of previous cesarean scar defect from January 2010 to October 2014，in the Second people's Hospital of Yunnan Province. All patients were examined by hysteroscopy. 12 cases of patients with no fertility requirements were treated by electric cutting and plastic surgery with hysteroscopy. 9 cases of patients with fertility requirements were treated by hysteroscopy combined laparoscopic repair operation. Results The 21 patients were diagnosed by hysteroscopy. Among them，12 patients were treated with electric cutting by hysteroscopy ,the operation time was 25~45min.The average of the operation time was 35±10 min，.The blood loss was 2~10 ml. The average of the blood loss was6±4 ml. Among them，9 patients were treated with hysteroscopy combined laparoscopic，the operation time was 90~165min.The average of the operation time was 127.5±37.5 min.The blood loss was 30～80 mL.The average of the blood loss was 55±25 mL. With postoperative follow-up office visit of 6 months，the postoperative 1 menstrual period of 21 patients recovered back to normal，and all were in the normal range in a half years. After 6 months，recurrence were found in 3 cases with simple hysteroscopic treatment，and no recurrence in the patients treated with hysteroscopycombined laparoscopic treatment. Conclusions Hysteroscopy examination is expected to become the gold standard of examination of the previous cesarean scar defect. Two kinds of operation can effectively relieve symptoms in the short term，and each has advantages. Electrotomy with hysteroscope is convenient in operation，short operation time and less intraoperative bleeding. Repair surgery with hysteroscopy combined laparoscopy has obvious curative effect and low rate of recurrence. The two methods are worthy to be popularized in clinic. But the long-term effect needs to be further observed. |
| Key words: ［Key words］Previous cesarean scar defect Hysteroscopy Laparoscopy |