CAJ | 학술논문

目的：探讨宫腔镜联合B超在诊断二次剖宫产术后子宫切口憩室中的应用价值。方法对2012年5月～2013年5月有二次剖宫产术史的38例进行宫腔镜检查，对剖宫产子宫切口宫腔镜下图像和联合B超的声像学特征进行回顾性分析。结果宫腔镜联合 B超检查诊断剖宫产子宫切口憩室34例，检出率89．5％（34/38），其中轻型憩室18例（47.4％），16例重型憩室16例（42．1％），愈合良好4例（10．5％）。重型憩室顶端距离浆膜面的距离1．6～6．0 mm，宽度3～17 mm。术前经阴道超声（ transvaginal ultrasonography ， TVS）仅在重型憩室患者中诊断10例剖宫产子宫切口憩室，检出率26.3％（10/38）。术前TVS和宫腔镜联合B超对子宫切口憩室的检出率有统计学差异（χ2＝31．091，P＝0．000）。结论宫腔镜联合B超对二次剖宫产术后子宫切口憩室有较高的检出率，值得临床推广为二次剖宫产术后常规的微创检查方法。
목적：탐토궁강경연합B초재진단이차부궁산술후자궁절구게실중적응용개치。방법대2012년5월～2013년5월유이차부궁산술사적38례진행궁강경검사，대부궁산자궁절구궁강경하도상화연합B초적성상학특정진행회고성분석。결과궁강경연합 B초검사진단부궁산자궁절구게실34례，검출솔89．5％（34/38），기중경형게실18례（47.4％），16례중형게실16례（42．1％），유합량호4례（10．5％）。중형게실정단거리장막면적거리1．6～6．0 mm，관도3～17 mm。술전경음도초성（ transvaginal ultrasonography ， TVS）부재중형게실환자중진단10례부궁산자궁절구게실，검출솔26.3％（10/38）。술전TVS화궁강경연합B초대자궁절구게실적검출솔유통계학차이（χ2＝31．091，P＝0．000）。결론궁강경연합B초대이차부궁산술후자궁절구게실유교고적검출솔，치득림상추엄위이차부궁산술후상규적미창검사방법。
Objective To investigate the diagnostic value of hysteroscopy combined with B -ultrasonography for uterine incision diverticulum after secondary cesarean section . Methods From May 2012 to May 2013, hysteroscopy check was performed in 38 cases with a history of two times of caesarean sections . The hysteroscopic results and ultrasound images were analyzed retrospectively . Results Incision diverticulum was diagnosed in 34 cases by using diagnostic hysteroscopy combined with B-ultrasonography, with a diagnosis rate of 89.5%(34/38).There were 18 cases of mild diverticulum (47.4%), 16 cases of severe diverticulum (42.1%), and 4 cases of good healing (10.5%).Of the 16 cases of severe diverticulum , the distance from top to serosal surface was 1.6-6.0 mm, and the width was 3-17 mm.Preoperative transvaginal ultrasonography ( TVS) showed only 10 cases of uterine incision diverticulum in patients with severe diverticulum , providing a diagnosis rate of 26.3% (10/38).Compared TVS with hysteroscopy combined with B-ultrasonography , there was a significant difference (χ2 =31.091, P=0.000) in the diagnosis rate for uterine incision diverticulum . Conclusion Hysteroscopy combined with B-ultrasonography has a high diagnosis rate for the diagnosis of uterine incision diverticulum in patients with two times of cesarean sections , being worthy of clinical application as a minimally invasive examination method after cesarean sections .