芪及逐瘀止血汤治疗剖宫产切口憩室的疗效  

Efficacy of Qiji Zhuyu Zhixue decoction in treating previous cesarean scar defect

作　　者：王琴晓 潘进力 胡明子 尤利益 林希 焦岩 WANG Qinxiao;PAN Jinli;HU Mingzi;YOU Liyi;LIN Xi;JIAO Yan(Department of Obstetrics and Gynecology Ultrasound,Wenzhou People’s Hospital,Wenzhou 325000,Zhejiang,China;Songtai Emergency Station,Wenzhou Emergency Medical Services,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市人民医院妇产超声科,浙江温州325000 [2]温州市急救中心松台急救站,浙江温州325000

出　　处：《中国现代医生》2024年第25期81-84,共4页China Modern Doctor

基　　金：浙江省温州市科研项目(Y20220464)。

摘　　要：目的探讨芪及逐瘀止血汤治疗剖宫产切口憩室(previous cesarean scar defect,PCSD)的临床效果,并探讨经阴道二维超声联合三维能量多普勒超声(three-dimensional power Doppler ultrasound,3D-PDUS)诊断PCSD的价值。方法选取2023年4月至10月于温州市人民医院诊治的PCSD患者120例为研究对象,随机将患者分为病例组(50例)和对照组(70例)。病例组患者给予芪及逐瘀止血汤治疗,对照组患者给予去氧孕烯炔雌醇片治疗。比较两组患者治疗6个月后的临床效果,使用二维超声联合3D-PDUS评估两组患者治疗前后的PCSD长度、宽度、深度、外侧肌层厚度、容积。采用受试者操作特征曲线评估超声参数在诊断PCSD中的效能。结果治疗6个月后,病例组患者的总有效率显著高于对照组(χ^(2)=21.97,P<0.01)。治疗后,病例组患者的憩室深度和容积均显著小于治疗前(P<0.05);病例组患者的憩室深度显著小于对照组(P<0.05);病例组患者的外侧肌层厚度显著大于本组治疗前和对照组(P<0.05)。憩室深度、憩室外侧肌层厚度和憩室容积联合诊断PCSD的曲线下面积为0.707。结论芪及逐瘀止血汤治疗PCSD的临床效果显著;经阴道二维超声联合3D-PDUS是诊断PCSD的首选检查方法,值得推广应用。Objective To investigate the clinical effect of Qiji Zhuyu Zhixue decoction in treatment of previous cesarean scar defect(PCSD)and explore the value of transvaginal two-dimensional ultrasound combined with three-dimensional power Doppler ultrasound(3D-PDUS)in the diagnosis of PCSD.Methods A total of 120 PCSD patients treated and treated in Wenzhou People’s Hospital from April to October 2023 were selected as study objects,and they were randomly divided into case group(50 cases)and control group(70 cases).The case group was treated with Qiji Zhuyu Zhixue decoction,and the control group was treated with desogestrel and ethinylestradiol tablets.The clinical effects after 6 months of treatment were compared between two groups.The length,width,depth,lateral muscle thickness and volume of PCSD before and after treatment were evaluated by two-dimensional ultrasound combined with 3D-PDUS.The receiver operating characteristic curve was used to evaluate the efficacy of ultrasonic parameters in diagnosis of PCSD.Results After 6 months of treatment,the total effective rate of case group was significantly higher than that of control group(χ^(2)=21.97,P<0.01).After treatment,the diverticulum depth and volume in case group were significantly lower than before treatment(P<0.05).The diverticulum depth in case group was significantly lower than that in control group(P<0.05).The lateral muscle thickness in case group was significantly greater than that before treatment and control group(P<0.05).The area under the curve of the combined diagnosis of PCSD with diverticular depth,diverticular lateral muscle thickness and diverticular volume was 0.707.Conclusion The clinical effect of Qiji Zhuyu Zhixue decoction on PCSD is remarkable.Transvaginal two-dimensional ultrasound combined with 3D-PDUS is the first choice for the diagnosis of PCSD,and it is worth popularizing and applying.

关 键 词：剖宫产切口憩室 三维能量多普勒超声 芪及逐瘀止血汤 去氧孕烯炔雌醇片 诊断效能 

分 类 号：R711.5[医药卫生—妇产科学]