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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。
Objective To study the effect and influential factors of transvaginal repair of uterine scar diverticulum in the treatment of cesarean section incision and diverticula (PCSD) and verify the accuracy of transvaginal ultrasonography in diagnosing PCSD. Methods 35 cases of clinical symptoms after cesarean section were transvaginal B-mode ultrasound and hysteroscopy to calculate the detection rate of transvaginal B-mode ultrasound. All patients underwent vaginal surgery to repair uterine scar diverticulum. The follow-up results were observed and the influencing factors were analyzed. Results The detection rate of PCSD by Vaginal Ultrasound was 88.6% (31/35). Vaginal surgery to repair uterine scar diverticulum treatment of PCSD efficiency was 68.6%, of which, the first uterine effective rate (92.9%) higher than the posterior uterus (52.4%), single cesarean section in patients with operative efficiency (93.3% ) Was higher than multiple cesarean section (50.0%), but the patient’s age, onset time and the duration of preoperative vaginal bleeding had no effect on the operation. CONCLUSIONS: Vaginal ultrasound diagnosis is the best choice for PCSD, but the rate of misdiagnosis should be monitored. Vaginal surgery to repair the uterine diverticulum in the treatment of anterior uterus and single cesarean postoperative PCSD better.