Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Reprod Sci. 2011 Dec;18(12):1166-85. doi: 10.1177/1933719111414206. Epub 2011 Jul 20.
In this review, we discuss the pathophysiology of adhesion development, the impact of physiological changes associated with pregnancy on markers of adhesion development, and the clinical implications of adhesion development following cesarean delivery (CD). Although peritoneal adhesions develop after the overwhelming majority of intra-abdominal and pelvic surgery, there is evidence in the literature that suggests that patients having CD may develop adhesions less frequently. However, adhesions continue to be a concern after CD, and are likely significant, albeit on average less than after gynecological operations, but with potential to cause significant delay in the delivery of the baby with serious, lifelong consequences. Appreciation of the pathophysiology of adhesion development described herein should allow a more informed approach to the rapidly evolving field of intra-abdominal adhesions and should serve as a reference for an evidence-based approach to consideration for the prevention and treatment of adhesions.
在这篇综述中，我们讨论了粘连形成的病理生理学，与妊娠相关的生理变化对粘连形成标志物的影响，以及剖宫产（CD）后粘连形成的临床意义。尽管绝大多数的腹腔内和盆腔手术后都会发生腹膜粘连，但文献中有证据表明，CD 患者发生粘连的频率可能较低。然而，CD 后粘连仍然是一个值得关注的问题，尽管粘连的平均程度低于妇科手术后，但仍有可能导致分娩延迟，并带来严重的终身后果。对本文所述粘连形成病理生理学的认识，应能使人们更深入地了解腹腔内粘连这一日益发展的领域，并为粘连的预防和治疗提供循证依据。
