子宫瘢痕憩室病理学变化与并发症的关系

The Relationship between Pathological Changes and Complications of Caesarean Scar Defect

子宫瘢痕憩室(caesarean scar defect,CSD)是指剖宫产术后子宫瘢痕的肌层缺损,使子宫内膜层向肌层突起,形成凹陷。由于瘢痕处愈合不良形成了异常的解剖学结构,并随着时间的推移而发生了一系列的病理学变化,如纤维组织的增生、迂曲血管的形成、激素受体的分布不均、炎症环境的出现及其他合并症等。CSD的病理学变化往往引起异常阴道出血、继发性不孕、痛经及慢性盆腔痛等并发症,影响女性的生活质量,给有生育要求的患者造成了极大的困扰。因此,CSD的诊治在临床工作中是不容忽视的。分析CSD形成的临床相关因素,探讨发生CSD病理学改变的危险因素,从而进一步明确CSD病理学变化与不同并发症的关系,更好地预防与诊治CSD及其并发症。

Caesarean scar defect(CSD)refers to the myometrial defect of the uterine scar after cesarean section,which causes the endometrial layer protrude to the myometrium and form a depression.Abnormal anatomical structures are formed due to poor healing of the scar,and a series of pathological changes have occurred over time,such as proliferation of fibrous tissue,formation of tortuous blood vessels,uneven distribution of hormone receptors,and inflammatory environment and other comorbidities.The pathological changes of CSD often cause complications such as abnormal vaginal bleeding,secondary infertility,dysmenorrhea and chronic pelvic pain,which affect the quality of life of women and cause great distress to patients with fertility requirements.Therefore,the diagnosis and treatment of CSD cannot be ignored in clinical work.The clinical related factors of CSD formation were analyzed,and the risk factors of CSD pathological changes were explored,so as to further study the relationship between CSD pathological changes and different complications,and better prevent,diagnose and treat CSD and its complications.