经阴道彩超在诊断瘢痕子宫妊娠中的价值(1)
【摘 要】目的：探讨经阴道彩超在瘢痕子宫妊娠中的诊断价值。方法：选取我院近两年收治的30例瘢痕子宫妊娠患者作为研究对象，患者均接受腹部超声诊断与阴道彩超诊断，并接受手术治疗，比较分析腹部超声与经阴道彩超在瘢痕子宫妊娠中的诊断价值。结果：经阴道超声检出率为96.67%，远高于经腹部超声检出率(80%)，比较有统计学意义(P<0.05)；以手术结果为金标准，则经阴道超声检出符合率明显大于经腹部超声(P<0.05)。阴道超声图像：妊娠物位于宫腔下段前壁疤痕部位，子宫肌层菲薄，妊娠物与肌层间界限模糊，回声杂乱；血流丰富，可见类滋养层低阻动脉样血管频谱；其中孕囊型16例，包块13例。结论：经阴道超声诊断瘢痕子宫妊娠准确性高，可清晰显示病灶、病灶周围组织情况，可为临床治疗提供有效价值。
【关键词】经阴道超声；腹部超声；瘢痕子宫妊娠
abstract objective： to explore the diagnostic value of transvaginal color doppler ultrasound in scar uterine pregnancy. Methods： a total of 30 patients with scar uterine pregnancy who had been treated in our hospital for nearly two years were selected as subjects. All the patients received abdominal ultrasound diagnosis and vaginal ultrasonography diagnosis， and received surgical treatment. The diagnostic value of abdominal ultrasound and transvaginal ultrasonography in scar uterine pregnancy was compared and analyzed. Results： the detection rate of transvaginal ultrasonography was 96.67%， much higher than that of transabdominal ultrasound (80%)， which was statistically significant (P<0.05). With the operation results as the gold standard， the coincidence rate of transvaginal ultrasonography was significantly higher than that of transabdominal ultrasound (P<0.05). Vaginal ultrasonography： the pregnancy was located at the scar site of the anterior wall of the lower segment of the uterine cavity， with thin myometrium， blurred boundaries between the pregnancy and the muscle layer， and disorderly echoes. The blood flow is abundant， and the arterioid vascular spectrum of the trophoblast layer is visible. There were 16 cases of cystic type and 13 cases of mass. Conclusion： the accuracy of transvaginal ultrasonography in diagnosing cicatricial uterine pregnancy is high， which can clearly show the lesion and surrounding tissue， which can provide effective value for clinical treatment.
Keywords： transvaginal ultrasonography； Abdominal ultrasound； Scar uterine pregnancy
【中图分类号】R714.22 【文献标识码】A 【文章编号】1672-3783(2018)11-03--01
流行病学调查显示剖宫产后瘢痕妊娠发生率为0.5%，近年来随着剖宫产人数的增加，瘢痕子宫妊娠发生率呈现出上升趋势[1]。不完全统计数据资料显示，异位妊娠中有1%-6%为瘢痕妊娠，随着孕囊增加，可出现胎盘植入、子宫破裂、大出血等严重后果，严重威胁患者生命安全，因此及时明确诊断并终止妊娠有着重要的临床意义[2]。阴道超声为瘢痕子宮妊娠的主要检查方法，为进一步明确其价值，笔者对我院近两年收治的30例经手术证实的瘢痕子宫妊娠患者进行研究分析，现将具体报告如下。
1 资料与方法
1.1 临床资料
选取我院自2016年1月至2018年1月收治的30例瘢痕子宫妊娠患者作为研究对象，年龄21-41岁，平均(32.10±2.33)岁；孕周7-20周，平均(15.77±2.01)周；均有剖宫产史，且为子宫下段横切口，剖宫产次数：1次8例，2次5例，≥3次17例。前次剖宫产距本次怀孕时间10个月-4年，平均(2.56±0.55)年。临床表现：阴道不规则出血15例，腹部疼痛15例，血清HCG检查均为阳性。, 百拇医药(范玉梅)
【关键词】经阴道超声；腹部超声；瘢痕子宫妊娠
abstract objective： to explore the diagnostic value of transvaginal color doppler ultrasound in scar uterine pregnancy. Methods： a total of 30 patients with scar uterine pregnancy who had been treated in our hospital for nearly two years were selected as subjects. All the patients received abdominal ultrasound diagnosis and vaginal ultrasonography diagnosis， and received surgical treatment. The diagnostic value of abdominal ultrasound and transvaginal ultrasonography in scar uterine pregnancy was compared and analyzed. Results： the detection rate of transvaginal ultrasonography was 96.67%， much higher than that of transabdominal ultrasound (80%)， which was statistically significant (P<0.05). With the operation results as the gold standard， the coincidence rate of transvaginal ultrasonography was significantly higher than that of transabdominal ultrasound (P<0.05). Vaginal ultrasonography： the pregnancy was located at the scar site of the anterior wall of the lower segment of the uterine cavity， with thin myometrium， blurred boundaries between the pregnancy and the muscle layer， and disorderly echoes. The blood flow is abundant， and the arterioid vascular spectrum of the trophoblast layer is visible. There were 16 cases of cystic type and 13 cases of mass. Conclusion： the accuracy of transvaginal ultrasonography in diagnosing cicatricial uterine pregnancy is high， which can clearly show the lesion and surrounding tissue， which can provide effective value for clinical treatment.
Keywords： transvaginal ultrasonography； Abdominal ultrasound； Scar uterine pregnancy
【中图分类号】R714.22 【文献标识码】A 【文章编号】1672-3783(2018)11-03--01
流行病学调查显示剖宫产后瘢痕妊娠发生率为0.5%，近年来随着剖宫产人数的增加，瘢痕子宫妊娠发生率呈现出上升趋势[1]。不完全统计数据资料显示，异位妊娠中有1%-6%为瘢痕妊娠，随着孕囊增加，可出现胎盘植入、子宫破裂、大出血等严重后果，严重威胁患者生命安全，因此及时明确诊断并终止妊娠有着重要的临床意义[2]。阴道超声为瘢痕子宮妊娠的主要检查方法，为进一步明确其价值，笔者对我院近两年收治的30例经手术证实的瘢痕子宫妊娠患者进行研究分析，现将具体报告如下。
1 资料与方法
1.1 临床资料
选取我院自2016年1月至2018年1月收治的30例瘢痕子宫妊娠患者作为研究对象，年龄21-41岁，平均(32.10±2.33)岁；孕周7-20周，平均(15.77±2.01)周；均有剖宫产史，且为子宫下段横切口，剖宫产次数：1次8例，2次5例，≥3次17例。前次剖宫产距本次怀孕时间10个月-4年，平均(2.56±0.55)年。临床表现：阴道不规则出血15例，腹部疼痛15例，血清HCG检查均为阳性。, 百拇医药(范玉梅)