阴道三维超声对不规则型剖宫产术后切口瘢痕憩室的诊断价值.docVIP

阴道三维超声对不规则型剖宫产术后切口瘢痕憩室的诊断价值 　　[摘要] 目的 探讨阴道三维超声对不规则型剖宫产切口瘢痕憩室的诊断价值。方法 分别使用阴道三维超声和阴道二维超声，术前对60例在我院行宫腔镜手术的病人进行检查。观察切口瘢痕憩室的部位、形态，以不规则型憩室呈角状突出向子宫下段前侧壁/侧壁延伸部分的检出率为指标，以宫腔镜检查发现盲区为参照标准，将超声检查检出结果与其对照。结果 60例观察对象，二维超声组检出4例，与宫腔镜符合率30.77%，总检出率4.67%；三维超声组检出13例，与宫腔镜符合率100%，总检出率21.67%。两者比较差异有统计学意义（P0.05）。结论 阴道三维超声作为一种简便、经济、无创、可靠的检查方式，可对不规则型剖宫产术后切口瘢痕憩室的部位、形态作出准确的诊断，并对临床治疗方式的选择提供重要的参考依据。 　　[关键词] 阴道三维超声；不规则型；子宫切口瘢痕憩室；检出率 　　[中图分类号] R445.1 [文献标识码] A [文章编号] 2095-0616（2017）05-121-04 　　[Abstract] Objective To explore the clinical value of transvaginal three-dimensional ultrasonography in the diagnosis of Irregular type PCSD. Methods 60 cases of hysteroscopic surgery in our hospital were examined by 2D-TVS and 3D-TVS respectively before operation.The position and the shape of PCSD were observed. Irregular type PCSD with angular projection extend to front side wall/ side wall of lower uterine segment would be the positive indication. Detection the blind spot by Hysteroscopy would be the reference standard. The Ultrasound findings were compared. Results Among the 60 patients after ultrasonic testing，there were 4 cases detected in group 2D-TVS， and diagnostic accordance rate was 30.77%， total detection rate 4.67%. There were 13 cases detected in group 3D-TVS， and diagnostic accordance rate was 100%， total detection rate 21.67%. The differences between the two groups were statistically significant（P0.05）. Conclusion Transvaginal three-dimensional ultrasound is a simple， economic， safe and accurate inspection method. It can accurate diagnosis for the position and the shape of Irregular type PCSD， and it will be the important reference. 　　[Key words] Transvaginal three-dimensional ultrasound； Irregular type； PCSD； Detection rate 　　目前我国剖宫产率持续处于高位，特别在开放二胎政策后。剖宫产术后引起的子宫切口愈合不良，瘢痕憩室形成的病例不断增加。由此而引发月经异常、瘢痕妊娠、切口瘢痕憩室节育环嵌顿、切口瘢痕处胎盘植入、继发性切口瘢痕处子宫破裂等病理情况，其中月经异常的情况最为常见，对广大妇女的产后健康和生活造成深重影响。本研究探讨阴道三维超声对不规则型剖宫产术后切口瘢痕憩室诊断的作用，从而为妇产科临床对此类型憩室引起产后月经异常的患者在治疗方式上的选择提供帮助，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　以2012年6月～2016