中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
36期
93-94,96
,共3页
孙晓岩%袁秀英%刘小媚%杨仁东%刘燕燕%韩临晓
孫曉巖%袁秀英%劉小媚%楊仁東%劉燕燕%韓臨曉
손효암%원수영%류소미%양인동%류연연%한림효
剖宫产%剖宫产瘢痕缺损%发生率%危险因素%经阴道B超
剖宮產%剖宮產瘢痕缺損%髮生率%危險因素%經陰道B超
부궁산%부궁산반흔결손%발생솔%위험인소%경음도B초
Cesarean section%Cesarean scar defect%The incidence%Risk factors%B ultrasound via vagina
目的：探讨剖宫产瘢痕缺损的发生率及增加剖宫产瘢痕缺损深度的危险因素。方法：2011年7-12月收治行剖宫产妇女995例次，行经阴道B超检查了解子宫位置、切口距宫颈内口距离、缺损处肌层厚度，根据缺损处子宫肌层厚度，将患者分为大缺损组和小缺损组。结果：195例患者存在瘢痕缺损，发生率19.6%(195/995)；其中88例患者存在大缺损，发生率8.8%(88/995)，107例患者存在小缺损，发生率10.8%(107/995)。子宫后位、剖宫产次数≥2次、术前使用缩宫素、试产时间≥5 h、宫口扩张≥5 cm、胎先露已衔接、切口距宫颈内口＜5 mm的孕产妇大缺损的发生率明显升高。结论：子宫后位、切口距宫颈内口近、剖宫产次数多、使用缩宫素、试产时间长、宫口扩张程度大、胎先露衔接是增加剖宫产瘢痕缺损深度的危险因素，要加强对阴道分娩的准确评估。
目的：探討剖宮產瘢痕缺損的髮生率及增加剖宮產瘢痕缺損深度的危險因素。方法：2011年7-12月收治行剖宮產婦女995例次，行經陰道B超檢查瞭解子宮位置、切口距宮頸內口距離、缺損處肌層厚度，根據缺損處子宮肌層厚度，將患者分為大缺損組和小缺損組。結果：195例患者存在瘢痕缺損，髮生率19.6%(195/995)；其中88例患者存在大缺損，髮生率8.8%(88/995)，107例患者存在小缺損，髮生率10.8%(107/995)。子宮後位、剖宮產次數≥2次、術前使用縮宮素、試產時間≥5 h、宮口擴張≥5 cm、胎先露已銜接、切口距宮頸內口＜5 mm的孕產婦大缺損的髮生率明顯升高。結論：子宮後位、切口距宮頸內口近、剖宮產次數多、使用縮宮素、試產時間長、宮口擴張程度大、胎先露銜接是增加剖宮產瘢痕缺損深度的危險因素，要加彊對陰道分娩的準確評估。
목적：탐토부궁산반흔결손적발생솔급증가부궁산반흔결손심도적위험인소。방법：2011년7-12월수치행부궁산부녀995례차，행경음도B초검사료해자궁위치、절구거궁경내구거리、결손처기층후도，근거결손처자궁기층후도，장환자분위대결손조화소결손조。결과：195례환자존재반흔결손，발생솔19.6%(195/995)；기중88례환자존재대결손，발생솔8.8%(88/995)，107례환자존재소결손，발생솔10.8%(107/995)。자궁후위、부궁산차수≥2차、술전사용축궁소、시산시간≥5 h、궁구확장≥5 cm、태선로이함접、절구거궁경내구＜5 mm적잉산부대결손적발생솔명현승고。결론：자궁후위、절구거궁경내구근、부궁산차수다、사용축궁소、시산시간장、궁구확장정도대、태선로함접시증가부궁산반흔결손심도적위험인소，요가강대음도분면적준학평고。
Objective:To investigate the incidence of cesarean section scar defect and the risk factors of the increase of cesarean scar defect depth.Methods:995 women with cesarean section were selected from July to December 2011.They were given vaginal B ultrasound examination to understand uterine position,distance from cervical incision inside the mouth,the defect in the muscle layer thickness.According to the defect of uterine muscular layer thickness,the patients were divided into the large defect group and the small defect group.Results:195 patients had scar defect,and occurence rate was 19.6% (195/995);88 patients had the presence of large defect,and occurence rate was 8.8%(88/995);107 patients had small defect,and occurence rate was 10.8%(107/995).Large defect incidence of pregnant women with retroposition of uterus,cesarean section with more than 2 times,the preoperative use of oxytocin,pilot run longer than 5 hours,dilatation of cervix greater than 5 cm,cohesion of fetal presentation, incision from the endocervix less than 5 mm was increased obviously.Conclusion:Retroposition of uterus,cervix incision inside the mouth near distance,the more number of cesarean section,use of oxytocin,long trial production time,the large degree of cervical dilation,cohesion of fetal presentation were risk factors for the increase of cesarean scar defect depth.We must strengthen the accurate assessment of vaginal delivery.
