剖宫产手术子宫切口愈合不良及子宫憩室的防治

Prevention of poor healing of uterine incision and cesarean scar diverticulum after cesarean section

前次剖宫产瘢痕憩室(PCSD)作为剖宫产术后的远期并发症,近10年来受到越来越多的关注。PCSD增加了产科并发症:子宫破裂和胎盘粘连,而且也带来了术后疼痛、异常子宫出血、腹腔粘连及不孕等不良结局。文章从子宫切口的选择、缝合技术、缝合材料的选择及术后近期并发症的处理几方面探讨PCSD的预防措施。

As a long-term complication of cesarean section,previous cesarean scar diverticulum(PCSD)has attracted more and more attention in recent 10 years.PCSD increases the risk of two major obstetrical complications:uterine rupture and placenta accreta.Moreover,long-term adverse outcomes include pain,abnormal uterine bleeding,intraperitoneal adhesions and infertility.This article discusses the preventive measures of PCSD from the following aspects:the choice of uterine incision,the technique of uterine suture,the choice of suture materials and the management of postoperative short-term complications.