CAJ | 학술논문

目的：探讨经腹不同频率超声联合扫查瘢痕子宫前壁下段情况对指导孕产方式的价值。方法选择有一次剖宫产史孕妇323例，且均为子宫下段横切口。其中剖宫产8～12个月7例，13～24个月49例，25～36个月98例，＞37个月169例。应用经腹不同频率超声联合扫查瘢痕子宫前壁下段厚度及愈合情况，观察妊娠结局并与手术结果对比。结果随着剖宫时间的延长，Ⅰ级瘢痕子宫亦随之增加，以25～36个月以上增加最为明显，而Ⅱ级和Ⅲ级瘢痕相应减少。以25～36个月组为对照组，与8～12个月组和13～24个月组比较差异有统计学意义（ P ＜0.01）。而与＞37个月组比较差异无统计学意义（ P ＞0.05）。经手术证实，323例中有7例子宫破裂，破裂率约2.1％。其中8～12个月组中破裂率约28.6％；13～24个月组中破裂率约2.0％；25～36个月组中破裂率约1.0％；＞37个月组中破裂率约1.2％。以25～36个月组为对照组，与8～12个月组和13～24个月组比较差异有统计学意义（ P ＜0.01）。而与＞37个月组比较差异无统计学意义（ P ＞0.05）。结论经腹不同频率超声联合扫查可监测瘢痕子宫前壁下段厚度及连续性，评估测瘢痕愈合及瘢痕子宫分级情况，指导孕产妇的分娩方式，具有十分重要的意义。
목적：탐토경복불동빈솔초성연합소사반흔자궁전벽하단정황대지도잉산방식적개치。방법선택유일차부궁산사잉부323례，차균위자궁하단횡절구。기중부궁산8～12개월7례，13～24개월49례，25～36개월98례，＞37개월169례。응용경복불동빈솔초성연합소사반흔자궁전벽하단후도급유합정황，관찰임신결국병여수술결과대비。결과수착부궁시간적연장，Ⅰ급반흔자궁역수지증가，이25～36개월이상증가최위명현，이Ⅱ급화Ⅲ급반흔상응감소。이25～36개월조위대조조，여8～12개월조화13～24개월조비교차이유통계학의의（ P ＜0.01）。이여＞37개월조비교차이무통계학의의（ P ＞0.05）。경수술증실，323례중유7례자궁파렬，파렬솔약2.1％。기중8～12개월조중파렬솔약28.6％；13～24개월조중파렬솔약2.0％；25～36개월조중파렬솔약1.0％；＞37개월조중파렬솔약1.2％。이25～36개월조위대조조，여8～12개월조화13～24개월조비교차이유통계학의의（ P ＜0.01）。이여＞37개월조비교차이무통계학의의（ P ＞0.05）。결론경복불동빈솔초성연합소사가감측반흔자궁전벽하단후도급련속성，평고측반흔유합급반흔자궁분급정황，지도잉산부적분면방식，구유십분중요적의의。
Objective To explore the use of the transabdominal ultrasound with different frequency scanning anterior lower segment uterine scar situation for maternal guidance .Methods Pregnant women had a history of cesarean section 323 cases, and were lower uterine segment transverse incision .Of which seven cases of cesarean section were 8 months to 12 months, 49 patients 13 months to 24 months, 89 patients 25 months to 36 months, and more than 169 cases of 37 months.High-frequency ultrasound was use for ab-dominal and dynamic monitoring of different-year anterior lower segment uterine scar thickness and healing .Pregnancy outcomes ob-served were compared with surgery .Results With the extension of cesarean time , grade I uterine scar was also increased to 25~36 months (2 years ) which was the most obvious , and grade II and III scars were reduced accordingly .When group 25~36 months was used as the control group , there was statistically significant difference relative to group 8 ~12 months and 13 ~24 months ( P <0.01), but was no significant difference relative to group >37 months ( P >0.05).Among 323 cases, seven cases had uterine rup-ture that was confirmed by surgery with a rupture rate of about 2.1%.The rupture rate was about 28.6%in group 8~12 months, a-bout 2%in group 13~24 months, about 1.0%in group 25~36 months, and about 1.2%in group >37 months.When group 25~36 months was used as the control group , there was statistically significant difference relative to groups 8~12 months and 13~24 months ( P <0.01 ) , and was no significant difference relative to group >37 months ( P >0.05 ) .Conclusions Abdominal ultra-sound with different frequency scanning can monitor the thickness and continuity of anterior lower segment uterine scar to estimate the scar healing situation , and guide uterine scar grading .Therefore, it is great significance in guiding clinical decision of motherhood ap-proach.