剖宫产术后切口憩室的诊疗现状及进展

摘要

Post-cesarean section scar diverticulum (PCSD)is one of the long-term complications of cesarean section,the incidence of which is rising year by year with high cesarean section rate and with more aawareawareness of PCSD.Clinical manifestations of PCSD are mainly abnormal vaginal bleeding,menstrual cramps or abdominal pain,vaginal massive hemorrhage or uterine rupture due to repeat-ed pregnancy.Clinical diagnosis is mainly based on typical clinical manifestations,exclusion of endocrine diseases,and auxiliary exami-nation such as ultrasonography,MRI,HSG,hysteroscopy,among which ultrasonography was applied most widely.Treatments for PCSD are mainly drug therapy and surgery.Surgery can be carried out in patients when drug treatment is invalid,including abdominal vaginal repair,hysteroscopic surgery,laparoscopic surgery or joint operation.Different therapies are chosen based on the types of diverticulum in order to achieve a good therapeutic effect.%剖宫产术后切口憩室（PCSD）是剖宫产术远期并发症之一，近年来剖宫产率居高不下，且随着对 PCSD 的认识提高，其发生率逐年攀升。PCSD 临床上主要表现为阴道异常流血、痛经或下腹痛、再次妊娠致阴道大出血或子宫破裂可能等。临床诊断主要根据患者典型临床表现，排除内分泌疾病，同时结合辅助检查，如超声、磁共振（MRI）、子宫输卵管造影（HSG）、宫腔镜等，其中超声应用最广泛。PCSD 治疗主要采用药物治疗和手术治疗，对于药物治疗无效的患者可采用手术治疗，包括经腹、阴式修补术、腹腔镜手术、宫腔镜手术或联合手术等，根据憩室类型选择不同方式，以达到良好治疗效果。