剖宫产术后子宫瘢痕憩室的诊疗研究现状

Current Status of Diagnosis and Treatment Research on Cesarean Scar Diverticulum

剖宫产术后子宫瘢痕憩室(CSD)指剖宫产术后子宫下段切口愈合不良形成憩室样结构。这种憩室样结构的形成与女性的剖宫产次数、剖宫产时切口位置过低以及剖宫产术中的缝合方式等一系列高危因素息息相关。对于非妊娠期的女性,CSD可能会导致异常子宫出血、生育能力下降、慢性盆腔痛等症状;而对于妊娠期的女性,这种瘢痕憩室可能引起剖宫产术后子宫瘢痕妊娠。目前,经阴道超声为CSD的一线影像学检查途径,同时输卵管造影、宫腔镜检查以及磁共振成像等辅助检查方法也可帮助临床医师进行诊断。临床上,对CSD的治疗以手术为主,也可通过药物治疗缓解患者症状。而关于CSD的诊断标准仍需进一步探索。

Cesarean scar diverticulum(CSD)refers to the diverticulum like structure formed by poor healing of the incision in the lower segment of the uterus after cesarean section.The formation of diverticulotic-like structures is closely related to a series of risk factors such as the number of cesarean sections,the low position of the incision during cesarean section,and the suture method during cesarean section.For non-pregnant women,CSD may lead to abnormal uterine bleeding,decreased fertility,chronic pelvic pain and other symptoms;for pregnant women,this type of scar diverticulum may cause cesarean scar pregnancy.At present,transvaginal ultrasound is the first-line imaging examination method for CSD,and auxiliary examination methods such as salpingography,hysteroscopy,and magnetic resonance imaging can also help the clinical physicians diagnose.In clinical practice,surgery is the main treatment for CSD,and drug therapy can also be used to relieve the patients'symptoms.The diagnostic criteria of CSD still need to be further explored.