CAJ | 학술논문

目的：探讨剖宫产术后远期子宫出血原因、宫腔镜的临床诊断价值。方法对2011年1月至2014年1月我院妇科收治的剖宫产术后半年以上的异常子宫出血患者126例行诊断性宫腔镜检查,分析异常子宫出血原因,并对剖宫产术技巧进行探讨。结果发现与剖宫产相关病变36例,其中20例子宫下段憩室腔积血(15．8%),憩室合并息肉2例；11例剖宫产切口息肉(8．7%),4例子宫下段缝线残留(3．17%),1例剖宫产切口部位动静脉瘘(0．8%)。结论宫腔镜对剖宫产术后远期子宫出血具有明确诊断及治疗作用,小部分患者发病与剖宫产手术史有关,其中子宫下段憩室腔积血最常见。因此,严格掌握剖宫产指征,规范手术操作是减少剖宫产术后并发症的重要措施。
목적：탐토부궁산술후원기자궁출혈원인、궁강경적림상진단개치。방법대2011년1월지2014년1월아원부과수치적부궁산술후반년이상적이상자궁출혈환자126례행진단성궁강경검사,분석이상자궁출혈원인,병대부궁산술기교진행탐토。결과발현여부궁산상관병변36례,기중20례자궁하단게실강적혈(15．8%),게실합병식육2례；11례부궁산절구식육(8．7%),4례자궁하단봉선잔류(3．17%),1례부궁산절구부위동정맥루(0．8%)。결론궁강경대부궁산술후원기자궁출혈구유명학진단급치료작용,소부분환자발병여부궁산수술사유관,기중자궁하단게실강적혈최상견。인차,엄격장악부궁산지정,규범수술조작시감소부궁산술후병발증적중요조시。
Objective To investigate the reasons and effects of hysteroscopy in long-term uterine bleeding after Cesarean Section Forward. Methods From Jan 2011 to Jan 2014,126 cases of who were suffering from uterine bleeding more than six months after cesarean section were diagnosed and treated hysteroscopically in our hospital. We analyzed their causes and cesarean section skills. Results 36 cases had the cesarean section related lesions. 20 of them with diverticulum in lower segment of uterine, 11 with cesarean scar polyps,4 with the remaining of sutures in lower segment of uterine,1 with cesarean scar arteriovenous fistula. Conclusion Hysteroscopy can accurately diagnose and cure the long term uterine bleeding after cesarean section. Some had the cesarean section related lesions,most of them were diverticulum in lower segment of uterine. Strict indications for cesarean section and improving cesarean section technique were the most important measures to reduce the complications after cesarean section.