子宫瘢痕憩室致异常子宫出血156例临床分析

Clinical analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum

目的：分析子宫瘢痕憩室引起异常子宫出血患者的临床表现、检查方法，为预防及治疗提供依据。方法回顾性分析因剖宫产术后子宫憩室引起异常子宫出血患者156例的临床资料，对检出率、患者临床症状出现时间及相关影响因素、检查情况、误诊情况进行分析。结果2010年异常出血者中发现憩室12例（5．6％），2011年发现憩室30例（10．5％），2012年发现憩室26例（8．6％），2013年发现憩室37例（14.4％），2014年发现憩室51例（17．7％）。48例患者症状出现时间为术后恢复月经1～6个月，89例为术后恢复月经6个月至2年，19例为术后恢复月经2年后。98例（62．82％）患者多次超声检查未发现明显异常，43例患者行诊断性刮宫，后位子宫与前位、中位子宫相比阴道流血时间明显延长。结论剖宫产子宫切口憩室致异常子宫出血发病率虽低，但是有较高的误诊、漏诊率，需进一步提高其诊断率，进一步研究其预防及治疗方法。

Objective To investigate the clinical manifestation and inspection method about abnormal uter-ine bleeding due to cesarean section scar diverticulum.Methods retrospective analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum.Analysis the relevance ratio,the starting time of clinical symptom,related influencing factors,the information of examine and misdiagnose.Results there are 12 cases cesare-an section scar diverticulum in 2010;30 cases in 2011;26 cases in 2012;37 cases in 2013;51 cases in 2014.The starting time of clinical symptom is 1 ~6 month pose menstrual in 48 cases;6 months to 2 years pose menstrual in 89 cases,2 years later pose menstrual in 19 cases.98 cases don′t have evidential abnormality even through many times ultrasonograph.43 patients subjected diagnosis curettage.The uterine bleeding time obviously longer comparing retro-position of uterus with anteposition and msposition of uterus.Conclusion the morbidity of abnormal uterine bleeding cases due to cesarean section scar diverticulum is low,but the rate of misdiagnosis and missed diagnosis is little high-er.We need to elevate the rate of diagnosis,and to research the preservation and magagement gradually.