剖宫产后子宫腔形态的三维超声成像研究

Study on post-cesarean uterine cavity morphology using three-dimensional ultrasonography

目的探讨剖宫产后子宫腔形态的三维超声成像特征及其临床意义。方法剖宫产组138例和自然分娩组140例,应用三维超声的冠状切面成像,观察子宫内膜腔形态并测量宫腔内各径线值,比较分析其结果。结果剖宫产组中宫腔呈狭长三角形态子宫和不规则形态子宫者共45例(32.6%),自然分娩组仅10例(7.1%),两组比较差异有统计学意义(P﹤0.05);剖宫产组子宫腔横径(2.78±0.56)cm,明显小于自然分娩组(3.07±0.72)cm,而剖宫产组子宫宫腔纵径为(5.17±0.83)cm,大于自然分娩组(4.53±0.77)cm,两组宫腔纵、横径比较差异有统计学意义(P﹤0.05);但两组宫颈长径测量数值比较差异无统计学意义。结论剖宫产后宫腔的狭长形态和不规则子宫形态改变明显多于自然分娩。三维超声成像能准确反映剖宫产后子宫腔形态的变化特征,为临床提供直观的图文信息,起到指导临床的作用。

Objective To investigate the post-cesarean uterine cavity morphology and its clinic value by the three- dimensional uhrasonography. Methods Altogether 278 cases were divided into two groups, including post-cesarean group（ 138 cases） and natural labor group（ 140 cases）. The data of uterine cavity morphology were collected using three-dimensional ultrasonography from coronal section, and the data were compared between the two groups. Results The percentage of irregular and long triangle shape in post-cesarean group（45/138, 32.6% ） was significantly higher than that of natural labor group （ 10/140,7.1% ）, there was significant difference（P 〈 0.05 ）. The transverse diameter of the post-cesarean group （2.78±0.56）cm was significantly shorter than that of natural labor group （3.07±0.72）cm, but the longitudinal diameter of the post-cesarean group （5.17±0.83）cm was greater than that of natural labor group（4.53±0.77 ）cm, there was significant difference （P 〈 0.05 ）. No significant difference was found in cervix diameter between the two groups. Conclusion The cesarean is the main reason for uterus cavity shape changing into long, narrow and irregular shape. Three-dimensional ultrasonography can accurately reflects the characteristics of uterine cavity morphology, providing valuable information and guide clinic.