宫腔镜联合B超在剖宫产术后子宫切口憩室诊断中的应用价值
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摘要
目的探究宫腔镜联合B超在剖宫产术后子宫切口憩室诊断中的应用价值。方法选取2016年3月至2017年3月在我院行宫腔镜联合B超检查的42例有二次剖宫产术史患者为研究对象,对其检查结果进行回顾性分析,并比较阴道超声(TVS)、宫腔镜联合B超对剖宫产术后子宫切口愈合情况的检查结果及其对剖宫产术后子宫切口憩室的诊断情况。结果宫腔镜联合B超对剖宫产术后子宫切口憩室的检出率明显高于TVS,差异具有统计学意义(P<0.05)。宫腔镜联合B超检查剖宫产术后子宫切口憩室的缺损长度、宽度、深度均显著优于TVS,差异具有统计学意义(P<0.05)。结论与TVS相比,宫腔镜联合B超在剖宫产术后子宫切口憩室诊断中的应用效果更为显著,其可有效提高疾病检出率及准确率,操作简单,值得临床进一步推广应用。
Objective To explore the application value of hysteroscopy combined with B-ultrasound in the diagnosis of post-cesarean section scar diverticulum. Methods From March 2016 to March 2017, 42 patients with history of second cesarean section who underwent hysteroscopy combined with B-ultrasound in our hospital were selected as the research objects and the results of the examination were analyzed retrospectively. The results of transvaginal ultrasonography(TVS)and hysteroscopy combined with B-ultrasound on the healing of uterine incision after cesarean section and the diagnosis of post-cesarean section scar diverticulum by the two methods were compared. Results The detection rate of post-cesarean section scar diverticulum by hysteroscopy combined with B-ultrasound was significantly higher than that by TVS, and the difference was statistically significant(P<0.05). The defect length, width and depth of post-cesarean section scar diverticulum examined by hysteroscopy combined with B-ultrasound were significantly better than those examined by TVS, and the differences were statistically significant(P<0.05). Conclusion Compared with TVS, hysteroscopy combined with B-ultrasound is more effective in the diagnosis of post-cesarean section scar diverticulum, which can effectively improve the detection rate and accuracy of disease, with simple operation. It is worthy of further clinical promotion and application.
Objective To explore the application value of hysteroscopy combined with B-ultrasound in the diagnosis of post-cesarean section scar diverticulum. Methods From March 2016 to March 2017, 42 patients with history of second cesarean section who underwent hysteroscopy combined with B-ultrasound in our hospital were selected as the research objects and the results of the examination were analyzed retrospectively. The results of transvaginal ultrasonography(TVS)and hysteroscopy combined with B-ultrasound on the healing of uterine incision after cesarean section and the diagnosis of post-cesarean section scar diverticulum by the two methods were compared. Results The detection rate of post-cesarean section scar diverticulum by hysteroscopy combined with B-ultrasound was significantly higher than that by TVS, and the difference was statistically significant(P<0.05). The defect length, width and depth of post-cesarean section scar diverticulum examined by hysteroscopy combined with B-ultrasound were significantly better than those examined by TVS, and the differences were statistically significant(P<0.05). Conclusion Compared with TVS, hysteroscopy combined with B-ultrasound is more effective in the diagnosis of post-cesarean section scar diverticulum, which can effectively improve the detection rate and accuracy of disease, with simple operation. It is worthy of further clinical promotion and application.
引文
[1]侯磊,李光辉,邹丽颖,等.全国剖宫产率及剖宫产指征构成比调查的多中心研究[J].中华妇产科杂志,2014,49(10):728-735.
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[7]钱晨,施卫平.经阴道超声检查对剖宫产术后子宫切口憩室的诊断价值[J].南通大学学报:医学版,2014,34(5):444-445.
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[9]江英.经阴道超声对剖宫产后子宫切口憩室的诊断价值分析[J].基层医学论坛,2015,19(7):1005-1006.
[10]文美莲,张全华,郭潇,等.宫腹腔镜联合修补剖宫产子宫切口憩室的临床分析[J].微创医学,2015,10(3):368-369.
[11]温海群,张岚,李金莉,等.经阴道超声在剖宫产术后子宫切口憩室诊断中的应用[J].中国临床研究,2015,28(2):246-248.
[12]卢祥章.阴道超声联合宫腔镜诊断剖宫产术后子宫切口憩室的临床价值分析[J].中国现代医药杂志,2017,19(5):34-36.
[13]杨丽曼,吴青青.经阴道三维超声对剖宫产术后子宫切口憩室的诊断价值[J].中国现代医生,2013,51(26):22-24.
[14]陈慧军,吴一萍,吴秀英.阴道超声联合宫腔镜对剖宫产术后子宫切口憩室的诊断价值[J].中华全科医学,2015,13(7):1132-1133,1178,1211.
[15]付凤仙,段华,夏雪,等.B超联合宫腔镜在宫内妊娠组织残留诊断和治疗中的临床价值[J].中国微创外科杂志,2011,11(9):797-800.
[16]何浏铭.剖宫产切口憩室诊治中宫腔镜联合B超的应用分析[J].中外医疗,2013,32(22):181-182.
[17]郑文金.宫腔镜联合B超及腹腔镜在剖宫产切口憩室诊治中的应用评价[J].实用妇科内分泌杂志:电子版,2018,5(9):63-64.
[18]袁静,王玉兰,胡晓红.宫腔镜联合B超治疗7例剖宫产术后子宫切口憩室的分析[C].//全国慢性病诊疗论坛,2016.
[19]曾芳,蓝碧容,邹坤香.宫腔镜联合B超在诊断二次剖宫产术后子宫切口憩室的临床观察[J].中国现代药物应用,2015,9(19):46-47.
[20]刘淼.宫腔镜联合B超及腹腔镜在剖宫产切口憩室诊治中的应用[J].中国医药指南,2017,15(1):148-149.
[21]叶广宁.经阴道超声联合宫腔镜在诊断剖宫产术后子宫切口憩室中的价值[J].中国实用医药,2017,12(19):78-79.
[22]邬久燕,李舟跃,黄海涛.宫腔镜B超腹腔镜在剖宫产术后子宫切口憩室的临床应用价值[J].浙江临床医学,2017,19(7):1268-1270.
[23]李丽竹.B超联合宫腔镜对二次剖宫产术后子宫切口憩室的诊断价值分析[J].基层医学论坛,2018,22(16):2260-2261.
[2] VAN DER VOET LF,BIJ DE VAATE AM,VEERSEMA S,et al.Longterm complications of caesarean section. The niche in the scar:a prospective cohort study on niche prevalence and its relation to abnormal uterine bleeding[J].BJOG,2014,121(2):236-244.
[3] TOWER AM,FRISHMAN GN.Cesarean scar defects:an underrecognized cause of abnormal uterine bleeding and other gynecologic complications[J].J Minim Invasive Gynecol,2013,20(5):562-572.
[4]郭银树,段华,张颖,等.宫腔镜联合B超及腹腔镜在剖宫产切口憩室诊治中的应用[J].中国微创外科杂志,2011,11(11):1019-1021.
[5]吴钟瑜,李慧东,张蕾.剖宫产术后子宫切口瘢痕处憩室的阴道超声诊断[J].中华妇产科杂志,2008,43(6):452-453.
[6] BIJ DE VAATE AJ,VAN DER VOET LF,NAJI O,et al.Prevalence,potential risk factors for development and symptoms related to the presence of uterine niches following cesarean section:systematic review[J].Ultrasound Obstet Gynecol,2014,43(4):372-382.
[7]钱晨,施卫平.经阴道超声检查对剖宫产术后子宫切口憩室的诊断价值[J].南通大学学报:医学版,2014,34(5):444-445.
[8]钟海燕.经阴道彩色多普勒超声对剖宫产切口憩室的诊断价值[J].中国中医药咨讯,2011,3(21):272.
[9]江英.经阴道超声对剖宫产后子宫切口憩室的诊断价值分析[J].基层医学论坛,2015,19(7):1005-1006.
[10]文美莲,张全华,郭潇,等.宫腹腔镜联合修补剖宫产子宫切口憩室的临床分析[J].微创医学,2015,10(3):368-369.
[11]温海群,张岚,李金莉,等.经阴道超声在剖宫产术后子宫切口憩室诊断中的应用[J].中国临床研究,2015,28(2):246-248.
[12]卢祥章.阴道超声联合宫腔镜诊断剖宫产术后子宫切口憩室的临床价值分析[J].中国现代医药杂志,2017,19(5):34-36.
[13]杨丽曼,吴青青.经阴道三维超声对剖宫产术后子宫切口憩室的诊断价值[J].中国现代医生,2013,51(26):22-24.
[14]陈慧军,吴一萍,吴秀英.阴道超声联合宫腔镜对剖宫产术后子宫切口憩室的诊断价值[J].中华全科医学,2015,13(7):1132-1133,1178,1211.
[15]付凤仙,段华,夏雪,等.B超联合宫腔镜在宫内妊娠组织残留诊断和治疗中的临床价值[J].中国微创外科杂志,2011,11(9):797-800.
[16]何浏铭.剖宫产切口憩室诊治中宫腔镜联合B超的应用分析[J].中外医疗,2013,32(22):181-182.
[17]郑文金.宫腔镜联合B超及腹腔镜在剖宫产切口憩室诊治中的应用评价[J].实用妇科内分泌杂志:电子版,2018,5(9):63-64.
[18]袁静,王玉兰,胡晓红.宫腔镜联合B超治疗7例剖宫产术后子宫切口憩室的分析[C].//全国慢性病诊疗论坛,2016.
[19]曾芳,蓝碧容,邹坤香.宫腔镜联合B超在诊断二次剖宫产术后子宫切口憩室的临床观察[J].中国现代药物应用,2015,9(19):46-47.
[20]刘淼.宫腔镜联合B超及腹腔镜在剖宫产切口憩室诊治中的应用[J].中国医药指南,2017,15(1):148-149.
[21]叶广宁.经阴道超声联合宫腔镜在诊断剖宫产术后子宫切口憩室中的价值[J].中国实用医药,2017,12(19):78-79.
[22]邬久燕,李舟跃,黄海涛.宫腔镜B超腹腔镜在剖宫产术后子宫切口憩室的临床应用价值[J].浙江临床医学,2017,19(7):1268-1270.
[23]李丽竹.B超联合宫腔镜对二次剖宫产术后子宫切口憩室的诊断价值分析[J].基层医学论坛,2018,22(16):2260-2261.