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目的:研究和探讨经阴道超声在评价剖宫产术后瘢痕愈合情况中的应用价值。方法:选取2015年6月至2016年4月佛山市顺德北滘医院收治的疑似子宫瘢痕妊娠产妇48名纳入观察组和正常产妇20名纳入对照组。比较腹部超声和经阴道超声对子宫瘢痕妊娠产妇子宫瘢痕愈合的评价结果、两组患者经阴道超声检查的子宫下段肌层厚度以及两组产妇分娩方式的选择和术中出血量。结果:经阴道超声能够更多地检测出子宫瘢痕愈合不佳的病例,组间比较,差异具有统计学意义(P<0.05)。观察组子宫瘢痕愈合Ⅰ级的产妇的子宫下段肌层厚度与对照组相似(P>0.05),Ⅱ级和Ⅲ级产妇的肌层厚度显著大于I级,差异具有统计学意义(P<0.05)。观察组子宫瘢痕愈合Ⅰ级的产妇的剖宫产率和术中出血量均与对照组比较,差异均无统计学意义(P>0.05),但明显低于Ⅱ级和Ⅲ级产妇,差异具有统计学意义(P<0.05)。结论:经阴道超声检查能够更加有效评估剖宫产术后瘢痕的愈合情况,降低并发症的发生,指导分娩方式的选择。
Objective: To study and explore the value of transvaginal ultrasound in the evaluation of scar healing after cesarean section. Methods: Forty-eight pregnant women with suspected uterine scar pregnancy admitted to Beidai Hospital of Shunde, Foshan City from June 2015 to April 2016 were enrolled in the observation group and 20 normal pregnant women were enrolled in the control group. Comparison of abdominal ultrasound and transvaginal ultrasound in uterine scar pregnancy maternal uterine scar healing evaluation results of two groups of patients by transvaginal sonography of the uterine muscle thickness and the two groups of maternal choice of mode of delivery and blood loss. Results: Transvaginal ultrasonography could detect more cases of poor healing of uterine scar. The differences between the two groups were statistically significant (P <0.05). The thickness of myometrium in the lower uterine segment of the uterine scar in the observation group was similar to that in the control group (P> 0.05). The thickness of the muscular layer in grade Ⅱ and Ⅲ was significantly higher than that of the grade I, the difference was statistically significant (P <0.05) . Cesarean section rate and intraoperative blood loss in the first grade of uterine scar healing women in the observation group were all significantly lower than those in the control group (P> 0.05), but were significantly lower than those in the second and third grade women Statistical significance (P <0.05). Conclusion: Transvaginal ultrasound can be more effective in assessing the healing of scar after cesarean section, reducing the incidence of complications and guiding the choice of mode of delivery.