剖宫产子宫疤痕病理与临床的关系

Association study between clinical factors and pathology of uterus scar caused by cesarean-section

目的探讨剖宫产子宫疤痕愈合与临床情况的关系。方法收集因妇科疾病切除的剖宫产子宫标本112例及同期无疤痕子宫标本11例,在子宫疤痕部位及无疤痕子宫组相应部位进行病理学检查。比较2组肌层及内膜厚度,平滑肌与胶原纤维比(平胶比)和血管数,以及疤痕子宫组中不同剖宫产年龄、距本次手术年限、缝合方法、缝线等与病理变化的关系。结果疤痕子宫组肌层厚度和血管数量大于无疤痕子宫组,平胶比低于无疤痕子宫组,差异有显著性意义(P<0.05)。而子宫内膜厚度差异无统计学意义(P>0.05)。疤痕子宫组中剖宫产时年龄、术后至今的年限、缝合方式、缝线、术者资格与疤痕厚度、平滑肌与胶原纤维比、炎症、玻璃样变性无相关关系。剖宫产年限与疤痕部位血管数呈负相关。结论子宫剖宫产疤痕结构薄弱、血供丰富。

Objective To explore the relationship between uterus scar of cesarean - section and some clinical factors. Methods The uterus samples were collected from women with hysterectomy caused by gynecological diseases, among whom 112 women experienced a cesarean- section （ study group） and 11 women did not （ control group）. The scared positions on the sampled uterus were assessed pathologically. Results There were significantly differeences between two groups in muscle thickness, the ratio of unstriped muscle and fibrous tissue and the number of vessels, but not in endometrium thickness. There were inverse association between the number of vessels in scared position and the span from the time of cesarean section to the time of hysterectomy. The muscle thickness, the ratio of unstriped muscle and fibrous tissue, infection and hyaline degeneration were not significantly associated with age, the span, the way of suture, the suture and surgeon. Conclusion The structure of the scared uterus was weak, but blood supply was sufficient.