评估阴式手术治疗剖宫产切口憩室的价值

发布时间：2018-03-29 15:57

本文选题：剖宫产切口憩室　切入点：阴式修补　出处：《海峡预防医学杂志》2016年06期

【摘要】：目的研究经阴道修补子宫疤痕憩室治疗剖宫产切口憩室(PCSD)的效果及影响因素,验证经阴道B超诊断PCSD的准确性。方法对35例剖宫产术后出现临床症状的患者,进行经阴道B超及宫腔镜检查,计算经阴道B超的检出率。所有患者均接受经阴道手术修补子宫疤痕憩室,术后随访观察手术效果,分析影响因素。结果经阴道B超诊断PCSD的检出率88.6%(31/35)。经阴道手术修补子宫疤痕憩室治疗PCSD的有效率为68.6%,其中,前位子宫有效率(92.9%)高于后位子宫(52.4%),单次剖宫产患者的手术有效率(93.3%)高于多次剖宫产(50.0%),而患者年龄、发病时间及术前阴道出血的持续时间,均未影响手术效果。结论 PCSD首选阴道B超诊断,但需警惕其漏诊率。经阴道手术修补子宫憩室在治疗前位子宫及单次剖宫产术后的PCSD效果较佳。
[Abstract]:Objective to study the effect and influencing factors of transvaginal repair of scar diverticulum in the treatment of cesarean incision diverticulum (PCSD), and to verify the accuracy of transvaginal ultrasonography in the diagnosis of PCSD. Methods 35 patients with clinical symptoms after cesarean section were enrolled in this study. Transvaginal ultrasonography and hysteroscopy were performed to calculate the detection rate of transvaginal ultrasonography. All the patients underwent transvaginal surgery to repair the uterine scar diverticulum. Results the detection rate of PCSD diagnosed by transvaginal ultrasound was 88.610 / 35. The effective rate of repairing scar diverticulum via vagina for PCSD was 68.6. The effective rate of anterior uterus (92.9) was higher than that of posterior uterus (52.4%). The effective rate of single cesarean section was 93.3%) higher than that of multiple cesarean section (50.0%), and the patient's age, onset time and duration of preoperative vaginal bleeding were higher than that of multiple cesarean section. Conclusion PCSD is the first choice for the diagnosis of vagina B ultrasound, but we should be aware of the rate of missed diagnosis. The transvaginal repair of diverticulum is better in the treatment of anterior uterus and single cesarean section.
【作者单位】：厦门大学附属第一医院妇产科;深圳武警总院生殖中心;厦门大学附属第一医院B超室;
【基金】：福建省自然科学基金项目(No.2016J01646) 厦门市科技惠民项目(No.3502Z20164004)
【分类号】：R713

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