B超诊断剖宫产宫壁瘢痕缺损及相关临床分析

目的探讨剖宫产宫壁瘢痕缺损的B超诊断。方法回顾性分析B超诊断剖宫产宫壁瘢痕缺损的结果及参数特点。结果本组共检出剖宫产宫壁瘢痕缺损57例,检出率为63.33%;剖宫产宫壁瘢痕缺损组经产妇瘢痕至宫颈内口距离及前位子宫率均明显低于剖宫产宫壁瘢痕完整组,差异具有统计学意义（P〈0.05或P〈0.01）;两组经产妇子宫内膜厚度、优势卵泡的直径、子宫长径、子宫前后径和子宫横径比较,差异无统计学意义（P〉0.05）;不同剖宫产次数及子宫前后位置宫壁瘢痕缺损参数相互比较,差异无统计学意义（P〉0.05）。结论剖宫产宫壁瘢痕缺损临床检出率较高,位置多接近于宫颈内口,子宫后位者发生剖宫产宫壁瘢痕缺损风险更高。

Clinical analysis on diagnosis of post-caesarean section scar defect by B ultrasonography

Objective To discuss diagnosis of post-caesarean section scar defect（PCSD） by B ultrasonography. Methods A retrospective analysis was conducted on the results and parameter characteristics of PCSD diagnosis by B ultrasonography. Results 57 cases of PCSD were detected with detection rate of 63.33%. The group with PCSD had significantly shorter distance between the scar and the internal cervix and significantly lower incidence of anteposition of uterus than the group with post-caesarean section intact scar, with statistical significance（P〈0.05 or P〈0.01）. The two groups had no statistical difference regarding endometrial thickness, diameter of dominant follicles, uterus length, uterine anterior-posterior diameter and uterus transverse diameter（P〈0.05）. There was no statistical difference regarding the number of caesarean sections and the parameters of post-caesarean section scar defect at anterior and posterior uterus（P〈0.05）. Conclusion PCSD has high detection rate in clinical practice and PCSD is often adjacent to the internal cervix. Patients with retroposition of uterus have higher risk of PCSD.