剖宫产术后不同年限子宫瘢痕的组织学与力学特征观察

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摘要目的了解子宫下段剖宫产术后不同年限子宫瘢痕的组织学与力学特征。方法收集2011-01到2013-12期间二次剖宫产病例。根据剖宫产术后间隔年限分为两组:短期组,前次剖宫产术日与二次剖宫产术日间隔＞1年且≤2年;长期组,间隔＞2年且≤5年。排除子宫瘢痕部位肌不连等切口愈合不良的病例。观察二次剖宫产前子宫下段厚度、肌肉与血管排列结构、胶原含量与子宫瘢痕组织抗拉强度。结果短期组与长期组子宫下段瘢痕部位超声检测厚度[(2.9±0.9)mm vs (3.3±0.6) mm],与离体测量厚度[(3.6±1.3)mm vs (4.2±1.2) mm],两组比较差异无统计学意义;子宫瘢痕部位肌肉(抗人β-actin单克隆抗体免疫染色)与胶原排列紊乱;短期组子宫瘢痕组织内胶原含量(39.3±7.1)μg/mg,显著高于长期组(33.3±7.6) μg/mg,P=0.022;但瘢痕组织的抗拉强度并无统计学差异。结论剖宫产术后不同年限子宫瘢痕的组织学与力学特征,并无统计学差异,但应尽量减少子宫伤口愈合不良。

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	王彩霞
	郭培奋
	胡晴丽

关键词 ：剖宫产, 子宫瘢痕, CD34

Abstract：Objective To study the histological and mechanical characteristics of cesarean uterine scar in different years post cesarean section(CS). Methods Patients were set into two groups according to the interval years post CS. Group 1: the interval periods between the two CS operation day were >1 year and ≤2 years; Group 2: interval >2 years and ≤5 years. Thickness of the LUS was detected by transabdominal ultrasound scan(TAUS) before CS and micrometer screw gauge once the samples of LUS were obtained. Arrangement of muscles (anti-β-actin) and blood vessels (anti-CD34) by immunohistochemistry, tensile strength of the uterine scar tissue were detected as well. Results The thickness of LUS scar were consistent between the groups, no matter what methods were used; muscle and collagen in the uterine scar were disorderly under optical microscopy, collagen content within “Group 1” (39.3±7.1) μg/mg, was significantly higher than “Group 2” (33.3±7.6) μg/mg, P=0.022; there were no significant differences between the tensile strength of the scar tissue. Conclusions The histological and mechanical characteristics of the anterior wall scar of LUS show no significant difference between less or more than 2 years, which needs strenuous efforts to avoid poor uterine wound healing.

Key words： cesarean section uterine scar CD34

收稿日期: 2014-10-09

ZTFLH:

R714.3

基金资助:广东省医学科学基金(A2011457)

通讯作者: 郭培奋,E-mail:guopeifen@aliyun.com

作者简介: 王彩霞,硕士,副主任医师,E-mail:wangcaixia@126.com

引用本文:

王彩霞, 郭培奋, 胡晴丽. 剖宫产术后不同年限子宫瘢痕的组织学与力学特征观察[J]. 武警医学, 2015, 26(9): 900-903. WANG Caixia, GUO Peifen, HU Qingli. Histology and biomechanical characteristics of uterine cesarean section (CS) scar in different years postcesarean section. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(9): 900-903.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2015/V26/I9/900

[1]	Ginsberg Y, Goldstein I, Lowenstein L, et al. Measurements of the lower uterine segment during gestation[J]. J Clin Ultrasound, 2013,41(4):214-217.
[1]	Ginsberg Y, Goldstein I, Lowenstein L, et al. Measurements of the lower uterine segment during gestation[J]. J Clin Ultrasound, 2013,41(4):214-217.
[2]	Kok N, Wiersma I C, Opmeer B C, et al. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous cesarean section: a meta-analysis[J]. Ultrasound Obstet Gynecol, 2013,42(2):132-139.
[2]	Kok N, Wiersma I C, Opmeer B C, et al. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous cesarean section: a meta-analysis[J]. Ultrasound Obstet Gynecol, 2013,42(2):132-139.
[3]	Buhimschi C S, Buhimschi I A, Yu C, et al. The effect of dystocia and previous cesarean uterine scar on the tensile properties of the lower uterine segment[J]. Am J Obstet Gynecol, 2006,194(3):873-883.
[3]	Buhimschi C S, Buhimschi I A, Yu C, et al. The effect of dystocia and previous cesarean uterine scar on the tensile properties of the lower uterine segment[J]. Am J Obstet Gynecol, 2006,194(3):873-883.
[4]	Bowers D, McKenzie D, Dutta D, et al. Growth hormone treatment after cesarean delivery in rats increases the strength of the uterine scar[J]. Am J Obstet Gynecol, 2001,185(3):614-617.
[4]	Bowers D, McKenzie D, Dutta D, et al. Growth hormone treatment after cesarean delivery in rats increases the strength of the uterine scar[J]. Am J Obstet Gynecol, 2001,185(3):614-617.
[5]	Morrione T G, Seifter S. Alterations in the collagen content of the human uterus during pregnancy and post-partum involution[J]. Einstein J Biol Med,2008,24(1):32-37.
[5]	Morrione T G, Seifter S. Alterations in the collagen content of the human uterus during pregnancy and post-partum involution[J]. Einstein J Biol Med,2008,24(1):32-37.
[6]	Cabuk D, Basaran G, Celikel C, et al.Vascular endothelial growth factor, hypoxia-inducible factor 1 alpha and CD34 expressions in early-stage gastric tumors: relationship with pathological factors and prognostic impact on survival[J]. Oncology, 2007,72(1-2):111-117.
[6]	Cabuk D, Basaran G, Celikel C, et al.Vascular endothelial growth factor, hypoxia-inducible factor 1 alpha and CD34 expressions in early-stage gastric tumors: relationship with pathological factors and prognostic impact on survival[J]. Oncology, 2007,72(1-2):111-117.
[7]	蒋英, 王淑珍. 再次剖宫产时对原子宫切口愈合情况相关因素分析[J]. 实用妇产科杂志,2006,7(22):430-435.
[7]	蒋英, 王淑珍. 再次剖宫产时对原子宫切口愈合情况相关因素分析[J]. 实用妇产科杂志,2006,7(22):430-435.
[8]	冯令达, 顾静珍, 陆慧娟, 等. 剖宫产子宫瘢痕病理与临床的关系[J]. 中国生育健康杂志,2007,18(3):144-146.
[8]	冯令达, 顾静珍, 陆慧娟, 等. 剖宫产子宫瘢痕病理与临床的关系[J]. 中国生育健康杂志,2007,18(3):144-146.
[9]	Pistofidis G, Makrakis E, Balinakos P, et al. Report of 7 uterine rupture cases after laparoscopic myomectomy: update of the literature[J]. J Minim Invasive Gynecol, 2012,19(6):762-767.
[9]	Pistofidis G, Makrakis E, Balinakos P, et al. Report of 7 uterine rupture cases after laparoscopic myomectomy: update of the literature[J]. J Minim Invasive Gynecol, 2012,19(6):762-767.
[10]	Glavind J, Madsen L D, Uldbjerg N, et al. Ultrasound evaluation of cesarean scar after single- and double-layer uterotomy closure: a cohort study[J]. Ultrasound Obstet Gynecol, 2013,42(2):207-212.
[11]	郑莉, 王树鹤. 子宫切口憩室研究主要进展[J]. 武警医学,2014,25(5):522-524.
[10]	Glavind J, Madsen L D, Uldbjerg N, et al. Ultrasound evaluation of cesarean scar after single- and double-layer uterotomy closure: a cohort study[J]. Ultrasound Obstet Gynecol, 2013,42(2):207-212.
[11]	郑莉, 王树鹤. 子宫切口憩室研究主要进展[J]. 武警医学,2014,25(5):522-524.
[12]	Nacheng Lin, Xin’an Li, Tianran Song, et al. The effect of collagen-binding vascular endothelial growth factor on the remodeling of scarred rat uterus following full-thickness injury[J]. Biomaterials,2012,33:1801-1807.
[12]	Nacheng Lin, Xin’an Li, Tianran Song, et al. The effect of collagen-binding vascular endothelial growth factor on the remodeling of scarred rat uterus following full-thickness injury[J]. Biomaterials,2012,33:1801-1807.