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目的探讨应用超声诊断剖宫产术后子宫与腹壁粘连的声像图特点和形成过程。方法选择剖宫产术后子宫与腹壁粘连患者29例,分析子宫与腹壁的粘连的形态、部位以及子宫体、子宫峽部、宫颈的长度改变等超声声像特征,并与30例剖宫产后无子宫腹壁粘连患者进行对照。结果剖宫产术后子宫与腹壁粘连的声像图特征为子宫前壁部分平行紧贴腹壁或局部呈“锥形”前凸于腹壁,部分声像表现腹壁呈部分“断裂样”改变。粘连部位宫体前壁与腹壁紧贴或嵌入,粘连部位下方宫体或峽部悬吊于腹壁,子宫峽部、宫体、宫颈长度明显大于对照组。结论超声诊断剖宫产后子宫与腹壁粘连准确、可靠,具有较高的临床诊断价值。能明确定位子宫被粘连的部位,子宫体、峽部的长度,对再次剖宫产或子宫相关手术,计划生育手术,宫内诊疗等具有较高临床意义。
Objective To explore the ultrasonographic diagnosis of cesarean section uterus and abdominal adhesion of sonography characteristics and formation process. Methods 29 patients with uterus and abdominal wall adhesions after cesarean section were selected. The morphology and location of uterus and abdominal wall adhesions, the length of uterine isthmus, isthmus and cervix were analyzed. Thirty cases with cesarean section After uterine abdominal adhesions patients without contrast. Results After cesarean section, the uterus and abdominal wall adhesion features of the eyelid wall were parallel to the anterior wall of the uterus or part of the “conical” anterior bulging in the abdominal wall, part of the abdominal wall showed part of the "change. The anterior wall and the abdominal wall of the adhesion site are closely attached or embedded, and the posterior wall of the uterus isthmus, the palace body and the cervix are obviously longer than the control group. Conclusion Ultrasound diagnosis of uterus and abdominal wall adhesions after cesarean section is accurate and reliable, and has high clinical diagnostic value. Can be clearly positioned uterine adhesions site, the length of the uterus, isthmus, cesarean section again or related uterine surgery, family planning surgery, intrauterine treatment has a higher clinical significance.