[1]付志刚,张晓磷,余成新,等.子宫切口憩室伴反复阴道大出血介入治疗一例并文献复习[J].介入放射学杂志,2014,(12):1092-1094.
 FU Zhi gang,ZHANG Xiao lin,YU Chen xin,et al.Interventional therapy of uterine incisional diverticula due to previous cesarean section associated with recurrent vaginal massive hemorrhage: report of one case with literature review[J].journal interventional radiology,2014,(12):1092-1094.
点击复制

子宫切口憩室伴反复阴道大出血介入治疗一例并文献复习 ()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2014年12期
页码:
1092-1094
栏目:
临床研究
出版日期:
2014-12-25

文章信息/Info

Title:
Interventional therapy of uterine incisional diverticula due to previous cesarean section associated with recurrent vaginal massive hemorrhage: report of one case with literature review
作者:
付志刚 张晓磷 余成新 李海涛 韩 强 张志刚 谭光喜
Author(s):
FU Zhi gang ZHANG Xiao lin YU Chen xin LI Hai tao HAN Qiang ZHANG Zhi gang TAN Guang xi.
Department of Interventional Radiology, Yichang Municipal Central People’s Hospital, the First Clinical Medical College, Three Gorges University, Yichang, Hubei Province 443003, China
关键词:
【关键词】 剖宫产术 子宫切口憩室 阴道大出血 介入治疗
文献标志码:
A
摘要:
【摘要】 目的 探讨剖宫产术后子宫切口憩室反复阴道出血的介入诊疗作用。方法 回顾我院1例剖宫产术后子宫切口憩室反复出血的盆腔动脉DSA表现及栓塞治疗,并结合文献复习该病发病原因、影像学表现及治疗方法。结果 患者因阴道反复出血前后共经历3次盆腔动脉DSA造影及栓塞治疗,短期止血效果肯定。DSA表现为子宫动脉、阴部内动脉参与供血,供血动脉均增粗、扭曲,右侧子宫弓状动脉增粗,左侧子宫末梢动脉可见对比剂外溢征象,未见明显肿瘤染色或动静脉瘘征象。最后经宫腔镜证实子宫切口瘢痕内多发小憩室形成,其内可见积血。后经开腹手术切除子宫切口瘢痕组织,随访1年未见出血复发。结论 子宫切口憩室DSA造影表现不具特征性,介入栓塞治疗协同2期外科根治术疗效肯定。

参考文献/References:

[1] Van Horenbeeck A, Temmerman M, Dhont M. Cesarean scar dehiscence and irregular uterine bleeding[J]. Obstet Gynecol, 2003, 102: 1137 1139.
[2] 施华芳, 黄 健. 剖宫产术后子宫切口憩室的阴道超声诊断价值[J]. 中国全科医学, 2010, 13: 2288 2289.
[3] Fabres C, Arriagada P, Fernández C, et al. Surgical treatment and follow up of women with intermenstrual bleeding due to cesarean section scar defect[J]. J Minim Invasive Gynecol, 2005, 12: 25 28.
[4] Keymer E. Dehiscence of old hysterectomy scar[J]. Bol Soc Chil Obstet Ginecol, 1955, 20: 87 90.
[5] 苏翠红. 剖宫产子宫切口憩室的诊疗进展[J]. 实用妇产科杂志, 2013, 29: 262 264.
[6] 丁景新, 陈建亮, 张宏伟, 等. 宫腹腔镜联合修补剖宫产术后子宫切口憩室[J]. 复旦学报: 医学版, 2012, 39: 506 510.
[7] 王马列, 梁润彩. 阴式手术治疗剖宫产术后子宫切口憩室53例疗效观察[J]. 暨南大学学报: 自然科学与医学版, 2013, 34: 417 420.
[8] Yazicioglu F, Gokdogan A, Kelekci S, et al. Incomplete healing of the uterine incision after caesarean section: Is it preventable [J]. Eur J Obstet Gynecol Reprod Biol, 2006, 124: 32 36.
[9] Hayakawa H, Itakura A, Mitsui T, et al. Methods for myometrium closure and other factors impacting effects on cesarean section scars of the uterine segment detected by the ultrasonography[J]. Acta Obstet Gynecol Scand, 2006, 85: 429 434.
[10] Wang CJ, Huang HJ, Chao A, et al. Challenges in the transvaginal management of abnormal uterine bleeding secondary to cesarean section scar defect[J]. Eur J Obstet Gynecol Reprod Biol, 2011, 154: 218 222.
[11] Uppal T, Lanzarone V, Mongelli M. Sonographically detected caesarean section scar defects and menstrual irregularity[J]. J Obstet Gynaecol, 2011, 31: 413 416.
[12] 付志刚, 李银萍, 李 银, 等. 介入栓塞术联合清宫术在治疗子宫切口妊娠中的应用价值[J]. 放射学实践, 2013, 28: 200 203.
[13] He M, Chen MH, Xie HZ, et al. Transvaginal removal of ectopic pregnancy tissue and repair of uterine defect for caesarean scar pregnancy[J]. BJOG, 2011, 118: 1136 1139.
[14] Luo L, Niu G, Wang Q, et al. Vaginal repair of cesarean section scar diverticula[J]. J Minim Invasive Gynecol, 2012, 19: 454 458.

备注/Memo

备注/Memo:
(收稿日期:2014-03-25)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2014-12-24