术后不同时期剖宫产瘢痕缺陷的形态学变化及影响因素分析

发布时间：2018-06-12 03:54

本文选题：剖宫产 + 瘢痕　；参考：《重庆医学》2017年07期

【摘要】：目的观察术后不同时期剖宫产瘢痕缺陷(CSD)形态学变化并分析其影响因素。方法选择足月剖宫产分娩的产妇1 167例作为研究对象,记录其临床资料,于产后6~8周及6个月行经阴道彩色多普勒超声(CDFI)检查剖宫产瘢痕愈合情况,观察CSD的形态学改变,比较各组间临床资料的差异。结果与可疑CSD组比较,CSD组残留子宫肌层厚度降低(t=4.530,P0.01);CSD组产后6个月时缺陷深度及残留子宫肌层厚度较产后6~8周发生明显改变(t=3.557、-4.090,P0.01);在瘢痕正常组、可疑CSD及CSD组3组间比较,多次剖宫产比率逐渐升高(χ2趋势=29.943,P0.01);与瘢痕正常组及可疑CSD组比较,CSD组紧急剖宫产比率明显升高(χ2=17.687、10.242,P0.01)。结论术后6~8周内的CSD有自行愈合的可能性,这种可能性与缺陷处残留子宫肌层的厚度有关。
[Abstract]:Objective to observe the morphological changes of cesarean scar defect (CSD) and analyze its influencing factors. Methods 1,167 pregnant women with term cesarean section were selected as the study subjects, and their clinical data were recorded. The scar healing of cesarean section was examined by transvaginal color Doppler ultrasound (CDFI) at 68 weeks and 6 months postpartum, and the morphological changes of CSD were observed. To compare the difference of clinical data among groups. Results compared with the suspected CSD group, the thickness of the residual myometrium in the CSD group was significantly lower than that in the CSD group at 6 months postpartum, and the thickness of the residual myometrium in the CSD group was significantly different from that in the 68 weeks postpartum group, while in the normal scar group, the thickness of the residual myometrium in the suspected CSD and CSD groups was significantly different from that in the normal scar group, and the thickness of the residual myometrial layer in the CSD group was higher than that in the 6 weeks postpartum group. The rate of cesarean section increased gradually (蠂 ~ 2 trend was 29.943), and the rate of emergency cesarean section in CSD group was significantly higher than that in normal scar group and suspected CSD group (蠂 ~ 2 ~ (17.687) 10.242 P 0.01). Conclusion CSD has the possibility of self-healing within 6 to 8 weeks postoperatively, which is related to the thickness of the residual myometrium in the defect.
【作者单位】：河南省人民医院产科;河南省人民医院超声科;
【分类号】：R714.259

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