剖宫产后子宫腔形态的三维超声成像特征及临床意义

Three-dimensional ultrasound imaging feature and its clinical significance of uterine cavity forms after cesarean

目的 探讨剖宫产后子宫腔形态的三维超声成像特征及临床意义.方法 将278例观察对象按不同分娩方式分成剖宫产组和自然分娩组,利用三维超声良好的冠状切面成像,观察子宫内膜腔形态及测量宫腔内各径线的值,并作比较分析.结果 两组对象的子宫腔形态改变所占百分率有明显差异,剖宫产组的狭长三角形态子宫和不规则形态子宫共有45例占32.6%,而自然分娩组的仅有10例占7.1%,两组间比较有显著性差异（P＜0.05）;剖宫产组的子宫腔横径[（2.78±0.56）cm]明显小于自然分娩组[（3.07±0.72）cm],而剖宫产组子宫的宫腔纵径[（5.17±0.83）cm]大于自然分娩组[（4.53±0.77 ）cm]（均P＜0.05）;而两组的宫颈长径测量数值比较无统计学意义（P＞0.05）.结论 剖宫产后子宫的狭长形态宫腔和不规则宫腔形态改变明显多于自然分娩.三维超声成像能准确地反映剖宫产后的子宫腔形态变化特征,为临床提供直观的图文信息,并起到指导临床的作用.

Objective To explore the three-dimensional ultrasound imaging feature and its clinical significance of uterine cavity forms after cesarean. Methods Two hundreds and seventy-eight women were divided into two groups according to their delivery types： caesarean section group or natural childbirth group.Their endometrial cavity shape was observed, and intrauterine diameters were measured by using good coronal three-dimensional ultrasound imaging. Comparison between the two groups was made. Results There was significantly different percentage between the two groups of objects morphological changes： 45 cases of the uterine cavity of cesarean section group were of narrow triangular shape or irregular shape uterus, accounting for 32.6%, while only 10 cases in natural childbirth group, accounting for 7.1%. Cesarean group uterine cavity diameter （2.78±0.56 cm） was significantly less than the natural delivery group （3.07±0.72cm）, and cesarean section group uterine cavity longitudinal diameter （5.17±0.83cm） was greater than the natural delivery group （4.53±0.77 cm）, （allP＜0.05）. Difference in the cervix diameter between the two groups was not statistically significant （P＞0.05）. Conclusions The long, narrow shape of the uterus and irregular uterine morphological changes after cesarean are significantly more than after natural childbirth. Dimensional ultrasound imaging can accurately reflect the characteristics of uterine cavity morphological changes after cesarean, provide graphic information for clinical use, and guide clinical practice.