摘要
剖宫产切口憩室是剖宫产术后远期子宫出血的主要原因,目前临床尚无统一的诊治标准。其临床表现主要为剖宫产后阴道不规则流血及不孕,再次妊娠可发生子宫破裂、切口妊娠大出血等。诊断需排除内分泌原因,分析病因,选择合理的辅助检查。治疗以中药、女性激素等保守治疗为主,但保守治疗效果较差时,应以手术治疗来促进憩室局部液体的流通,并切除病灶。选择手术方式时,要以憩室的类型为主要参考依据,主要采用子宫腔镜、腹腔镜、阴式手术等治疗手段。
Cesarean scar dehiscence is the primary cause for uterine bleeding in long term after cesarean section, currently there is no unified standard for its clinical diagnosis and treatment. The prominent clinical manifestations of it include menostaxis,irregular vaginal bleeding and infertility, uterine rupture and scar preg- nancy bleeding during the subsequent pregnancy, etc. It is necessary to exclude the endocrine factors when making the diagnosis, to analyze the causes, and to choose the reasonable auxiliary examinations. Current treat- ments are main/y based on the conservative treatment with traditional Chinese medicine, female hormone, etc.. But when the therapeutic effect of conservative treatment is poor,surgical treatment is suggested to improve the local fluid circulation in the diverticulum ,or even resect the lesion. According to the patients＇ condition and the diverticulum type,different individualized ways of surgical treatment should be appropriately selected, Hystero- scope,laparoscope and transvaginal operation are the effective options for surgical treatment.
出处
《医学综述》
2015年第5期833-836,共4页
Medical Recapitulate
关键词
剖宫产切口憩室
阴道流血
阴道超声
宫腔镜
Cesarean scar dehiscence
Uterine bleeding
Transvaginal ultrasonography
Hysteroscopy
