南通大学学报（医学版）
南通大學學報（醫學版）
남통대학학보（의학판）
JOURNAL OF NANTONG UNIVERSITY(MEDICAL SCIENCES)
2013年
6期
491-493,494
,共4页
瘢痕子宫%子宫下段%阴道试产%剖宫产%高频超声检查
瘢痕子宮%子宮下段%陰道試產%剖宮產%高頻超聲檢查
반흔자궁%자궁하단%음도시산%부궁산%고빈초성검사
scarred uterus%lower uterine segment%vaginal delivery%cesarean section%high frequency ultrasound
目的：探讨高频超声在剖宫产后瘢痕子宫再次妊娠分娩方式选择中的意义。方法：对122例有剖宫产史的孕妇再次妊娠后35周起采用高频探头，观察子宫下段的厚度及结构(其中下段厚度≥3 mm 67例，＜3 mm 55例)；下段厚度≥3 mm孕妇中32例进行阴道试产；＜3 mm适时行再次剖宫产术，于再次剖宫产术中对子宫下段情况进行比较。结果：(1)妊娠晚期瘢痕子宫孕妇子宫下段肌层厚度明显小于无瘢痕子宫孕妇(P＜0.05)；(2)高频超声显示子宫下段呈“鼠尾状”及“截断状”的病例，子宫不全破裂和瘢痕愈合不良的比例较“均匀一致”组高(χ2=27.99，P<0.05)；(3)瘢痕子宫下段厚度≥3 mm且超声呈“均匀一致”孕妇阴道试产率为47.76%，试产成功率为81.25%。结论：通过高频超声检查妊娠晚期瘢痕子宫下段肌层状态，为临床判断是否可以经阴道试产提供重要信息。
目的：探討高頻超聲在剖宮產後瘢痕子宮再次妊娠分娩方式選擇中的意義。方法：對122例有剖宮產史的孕婦再次妊娠後35週起採用高頻探頭，觀察子宮下段的厚度及結構(其中下段厚度≥3 mm 67例，＜3 mm 55例)；下段厚度≥3 mm孕婦中32例進行陰道試產；＜3 mm適時行再次剖宮產術，于再次剖宮產術中對子宮下段情況進行比較。結果：(1)妊娠晚期瘢痕子宮孕婦子宮下段肌層厚度明顯小于無瘢痕子宮孕婦(P＜0.05)；(2)高頻超聲顯示子宮下段呈“鼠尾狀”及“截斷狀”的病例，子宮不全破裂和瘢痕愈閤不良的比例較“均勻一緻”組高(χ2=27.99，P<0.05)；(3)瘢痕子宮下段厚度≥3 mm且超聲呈“均勻一緻”孕婦陰道試產率為47.76%，試產成功率為81.25%。結論：通過高頻超聲檢查妊娠晚期瘢痕子宮下段肌層狀態，為臨床判斷是否可以經陰道試產提供重要信息。
목적：탐토고빈초성재부궁산후반흔자궁재차임신분면방식선택중적의의。방법：대122례유부궁산사적잉부재차임신후35주기채용고빈탐두，관찰자궁하단적후도급결구(기중하단후도≥3 mm 67례，＜3 mm 55례)；하단후도≥3 mm잉부중32례진행음도시산；＜3 mm괄시행재차부궁산술，우재차부궁산술중대자궁하단정황진행비교。결과：(1)임신만기반흔자궁잉부자궁하단기층후도명현소우무반흔자궁잉부(P＜0.05)；(2)고빈초성현시자궁하단정“서미상”급“절단상”적병례，자궁불전파렬화반흔유합불량적비례교“균균일치”조고(χ2=27.99，P<0.05)；(3)반흔자궁하단후도≥3 mm차초성정“균균일치”잉부음도시산솔위47.76%，시산성공솔위81.25%。결론：통과고빈초성검사임신만기반흔자궁하단기층상태，위림상판단시부가이경음도시산제공중요신식。
Objective: To study association of high frequency ultrasound with the choice of delivery mode of scarred uterus after cesarean section. Methods: The thickness and structure of the lower uterine segment of 122 cases of pregnant women with a history of cesarean section were observed by using high frequency probe after 35 pregnant weeks(67 cases of the thick-ness of lower segment≥3 mm, 55 cases of the thickness of lower segment <3 mm). After communication with pregnant wom-en of the thickness of lower segment ≥3 mm, 32 cases chose vaginal delivery, and 55 cases of the thickness of lower seg-ment<3 mm chose cesarean section. The conditions of lower uterine segment were compared in cesarean section. Results:The thickness of lower uterine segment of scarred uterus in late trimester of pregnancy was significantly less than that of uterus without scar(P<0.05). The incidences of incomplete uterine rupture and poor healing of uterus incision of lower uterine seg-ment appearing in rat caudate and truncation in high frequency ultrasound were significantly higher than that appearing in u-niformity(both P<0.05). The rate of vaginal delivery of the thickness of lower uterine segment of scarred uterus ≥3 mm and appearing in uniformity was 47.76%, and the successful rate was 81.25%. Conclusion:The detection of lower uterine segment of scarred uterus by high frequency ultrasound can offer important information for vaginal delivery.
