剖宫产术后疤痕形成相关因素及盐水宫腔造影与经阴道超声评估剖宫产疤痕缺损的一致性评价  

The related factors of scar formation after cesarean section and the consistency evaluation of saline sonohysterography and transvaginal ultrasound in evaluating cesarean section scar defect

作　　者：罗秀琴 姜云 LUO Xiuqin;JIANG Yun(Department of Ultrasound,Quzhou Hospital of Traditional Chinese Medicine,Quzhou 324000,Zhejiang,China;Department of Gynecology,Quzhou Hospital of Traditional Chinese Medicine,Quzhou 324000,Zhejiang,China)

机构地区：[1]浙江省衢州市中医医院超声科,浙江衢州324000 [2]浙江省衢州市中医医院妇科,浙江衢州324000

出　　处：《中国性科学》2021年第8期102-105,共4页Chinese Journal of Human Sexuality

摘　　要：目的探讨剖宫产术后疤痕形成相关因素及盐水宫腔造影与经阴道超声评估剖宫产疤痕缺损的一致性。方法选取2017年4月至2018年5月浙江省衢州市中医医院收治的60例剖宫产术后剖宫产疤痕缺损患者作为研究对象,设为疤痕组。所有受试者均接受盐水宫腔造影与阴道超声检查,通过Bland-Altman分析评价阴道超声与盐水宫腔造影检查剖宫产疤痕缺损的一致性。另选取同期浙江省衢州市中医医院收治的60例剖宫产术后未发生剖宫产疤痕缺损的健康人群作为对照组。记录两组临床资料;采用多因素Logistic回归分析剖宫产疤痕缺损形成的危险因素。结果盐水宫腔造影声像特征与阴道超声影像特征结果显示,残存肌层厚度比较,差异无统计学意义(P>0.05);剖宫产疤痕缺损缝隙宽度、深度、剩余肌层比较,差异具有统计学意义(P<0.05);Bland-Altman分析评价阴道超声与盐水宫腔造影检查剖宫产疤痕缺损深度(ICC=98.33%)、深度(ICC=98.33%)及剩余肌层(ICC=98.33%)间具较好一致性。两组剖宫产切开部位、剖宫产数量、糖尿病、吸烟情况组间比较差异有统计学意义(P<0.05)。Logistic回归分析显示,剖宫产切开部位(OR=6.522,95%CI=2.115~20.112)、糖尿病(OR=7.333,95%CI=1.301~11.350)是剖宫产疤痕缺损形成的独立危险因素。结论盐水宫腔造影对剖宫产疤痕缺损的评价与阴道超声检测具较好一致性;剖宫产切开部位、糖尿病是引起剖宫产疤痕缺损形成的独立危险因素,临床干预过程中应重点关注。Objective To explore the related factors of scar formation after cesarean section and the consistency of saline sonohysterography and transvaginal ultrasound in evaluating cesarean section scar defects.Methods From April 2017 to May 2018,60 patients admitted to the Quzhou Hospital of Traditional Chinese Medicine with cesarean section scar defects after cesarean section were included in the scar group.All subjects underwent saline sonohysterography and vaginal ultrasonography,to evaluate the consistency of vaginal ultrasound and saline sonohysterography for cesarean section scar defects through Bland-Altman analysis.Another 60 cases admitted to the Quzhou Hospital of Traditional Chinese Medicine of cesarean section without scar defect in the same period were included in the control group.The clinical data of the two groups were recorded.Multivariate Logistic regression was used to analyze the risk factors of scar defect in cesarean section.Results There was no significant difference in residual muscle thickness between saline intrauterine contrast and vaginal ultrasound(P>0.05).The gap width,depth and residual muscle layer of scar defect in cesarean section had statistical significance(P<0.05).Bland-Altman analysis showed good consistency between vaginal ultrasound and saline intrauterine angiography in scar depth(ICC=98.33%),depth(ICC=98.33%)and remaining muscle layer(ICC=98.33%).There were statistically significant differences in the location of cesarean section,number of cesarean section,diabetes and smoking between the two groups(P<0.05).Logistic regression analysis showed that the location of cesarean section(OR=6.522,95%CI=2.115~20.112)and diabetes(OR=7.333,95%CI=1.301~11.350)were independent risk factors for scar formation of cesarean section.Conclusions The evaluation of cesarean section scar defects by saline sonohysterography is consistent with that of vaginal ultrasound.The incision site of cesarean section and diabetes are independent risk factors that cause scar defect formation in cesarean section,wh

关 键 词：盐水宫腔造影 阴道超声 剖宫产疤痕缺损 相关因素 

分 类 号：R714[医药卫生—妇产科学]