剖宫产术后不同年限子宫瘢痕的组织学与力学特征观察  

Histology and biomechanical characteristics of uterine cesarean section( CS) scar in different years postcesarean section

作　　者：王彩霞[1] 郭培奋[1] 胡晴丽[1] 

机构地区：[1]武警广东总队医院妇产科,广州510507

出　　处：《武警医学》2015年第9期900-903,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：广东省医学科学基金(A2011457)

摘　　要：目的了解子宫下段剖宫产术后不同年限子宫瘢痕的组织学与力学特征。方法收集2011-01到2013-12期间二次剖宫产病例。根据剖宫产术后间隔年限分为两组:短期组,前次剖宫产术日与二次剖宫产术日间隔>1年且≤2年;长期组,间隔>2年且≤5年。排除子宫瘢痕部位肌不连等切口愈合不良的病例。观察二次剖宫产前子宫下段厚度、肌肉与血管排列结构、胶原含量与子宫瘢痕组织抗拉强度。结果短期组与长期组子宫下段瘢痕部位超声检测厚度[(2.9±0.9)mm vs(3.3±0.6)mm],与离体测量厚度[(3.6±1.3)mm vs(4.2±1.2)mm],两组比较差异无统计学意义;子宫瘢痕部位肌肉(抗人β-actin单克隆抗体免疫染色)与胶原排列紊乱;短期组子宫瘢痕组织内胶原含量(39.3±7.1)μg/mg,显著高于长期组(33.3±7.6)μg/mg,P=0.022;但瘢痕组织的抗拉强度并无统计学差异。结论剖宫产术后不同年限子宫瘢痕的组织学与力学特征,并无统计学差异,但应尽量减少子宫伤口愈合不良。Objective To study the histological and mechanical characteristics of cesarean uterine scar in different years post cesarean section（ CS）. Methods Patients were set into two groups according to the interval years post CS. Group 1： the interval periods between the two CS operation day were 〉1 year and ≤2 years; Group 2： interval 〉2 years and ≤5 years. Thickness of the LUS was detected by transabdominal ultrasound scan（ TAUS） before CS and micrometer screw gauge once the samples of LUS were obtained. Arrangement of muscles（ anti-β-actin） and blood vessels（ anti-CD34） by immunohistochemistry,tensile strength of the uterine scar tissue were detected as well. Results The thickness of LUS scar were consistent between the groups,no matter what methods were used; muscle and collagen in the uterine scar were disorderly under optical microscopy,collagen content within＂Group 1＂（ 39. 3± 7. 1） μg / mg,was significantly higher than ＂Group 2＂（ 33. 3 ± 7. 6） μg / mg,P = 0. 022; there were no significant differences between the tensile strength of the scar tissue. Conclusions The histological and mechanical characteristics of the anterior wall scar of LUS show no significant difference between less or more than 2 years,which needs strenuous efforts to avoid poor uterine wound healing.

关 键 词：剖宫产 子宫瘢痕 CD34 

分 类 号：R714.3[医药卫生—妇产科学]