摘要
目的探讨经阴道超声诊断评估剖宫产瘢痕缺陷的分型及临床相关影响因素分析。方法经阴道超声常规扫查盆腔一般情况,重点观察记录子宫峡部前次剖宫产瘢痕处的解剖形态及回声情况,并同时记录月经情况,剖宫产切口类型,剖宫产次数等临床资料。结果 191例有剖宫产史的妇女中前次剖宫产瘢痕处超声图像异常的有76例(瘢痕缺陷发生率39.79%),瘢痕处超声图像无明显异常的115例。超声图像异常的表现类型主要有:类囊肿型43例(56.58%),V形或三角形15例(19.74%),楔形18例(23.68%)。超声图像正常组(115例)与超声图像异常组(76例)比较,二组的子宫异常出血率差异有统计学意义(P<0.05)。类囊肿形43例中,月经异常率72.09%(31/43)。V形或三角形15例中,月经异常率100%(15/15)。楔形18例中,月经异常率94.44%(17/18)(P<0.05),说明超声图像形态不同组间月经异常率差异有统计学意义。剖宫产切口类型(横切口与纵切口二种)、子宫位置(前位与后位)、剖宫产次数(1次或2次)在各组间分布差异有统计学意义(P<0.05)。类囊肿型、V型或三角型,楔型这三组中剖宫产瘢痕缺陷范围大小(即子宫纵切面峡部瘢痕缺陷处上下径×前后径)比较,差异有统计学意义(P<0.05)。上述三组间两两比较:类囊肿形与V形或三角形这二组间缺损范围大小差异无统计学意义(P>0.05),而类囊肿形与楔形组之间、V形或三角形与楔形二组间缺损范围大小差异有统计学意义(P<0.05)。三组间瘢痕缺陷前方的子宫肌层厚度组间差异有统计学意义。两两比较,类囊肿形与V形或三角形这二组间其前方肌层厚度尚差异无统计学意义(P>0.05),类囊肿形与楔形这二组间、V形或三角形与楔形二组间其前方肌层厚度差异有统计学意义(P<0.05)。结论经阴道超声能清楚显示剖宫产瘢痕处的解剖形态,可对瘢痕缺陷程度做出评估,因其无创、简单易行、可重复
Objective To investigate the classification and clinical analysis of transvaginal ultrasound in the diagnosis of cesarean scar defects. Methods Transvaginal ultrasound was used to scan routine pelvic general observation on anatomy and the echo records of uterine isthmus previous cesarean section scar. The clinical data such as menstruation, incision type of cesarean section and the times of cesarean section, etc. at the same time. Results Totally 191 women with a history of cesarean section in previous cesarean section scar were scaned by ultrasound image, abnormality in 76 cases （scar defect rate 39.79%）, other 115 cases of scar with no obvious abnormality; The main types of ultrasound image abnormalities were： cystic type （43 eases, 56.58% ）, V or triangle type （15 cases, 19.74%）, wedge type （18 cases, 23.68% ）. Ultrasound image normal group （115 cases） and ultrasound image abnormal group （76 cases）, the abnormal rate of menstruation between the two groups was statistically significant （P〈0.05）. ]n 43 cases of cystic type, the abnormal menstruation rate was 72. 09% （31/43）; in 15 cases of V or triangle type, the abnormal menstruation rate was 100% （15/15） ; in 15 cases of wedge type, the abnormal menstruation rate was 94.44% （17/18）. There were significant differences in the rate of abnormal menstruation between different types of ultrasound image （P〈0.05）. There were significant differences among three groups in type of cesarean section （P〈0.05）. There were significant differences among three groups in uterine position （P〈 0.05）. There were significant differences among three groups in the times of cesarean section. （P〈0.05） These three types of cesarean scar defect size（i, e. longitudinal surface before and after uterine isthmus scar defect on the size multiplied by the diameter） were significant difference（P〈0.05）. There was no signifi- cant difference in the size of scar defect between the groups of cystic type and triangle type �
出处
《中国煤炭工业医学杂志》
2017年第5期525-528,共4页
Chinese Journal of Coal Industry Medicine
关键词
经阴道超声
剖宫产瘢痕
Transvaginal ultrasonography
Cesarean section scar
