经阴道彩色多普勒超声检测剖宫产子宫疤痕妊娠中的临床意义研究.docVIP

经阴道彩色多普勒超声检测剖宫产子宫疤痕妊娠中的临床意义研究 　　[摘要] 目的 探讨剖宫产子宫疤痕妊娠（CSP）采用经阴道彩色多普勒超声检测的临床意义。 方法 随机选取2012年8月―2015年8月期间该院接收的50例子宫切口疤痕妊娠患者，均采用经腹和经阴道彩超检查，观察两种检查方式CSP诊断情况及声像分型。 结果 50例患者中，阴道超声诊断符合47例（94.0%），3例漏诊，2例为宫颈部妊娠，1例滋养细胞疾病，腹部超声诊断符合41例（82.0%），漏诊3例，误诊6例；阴道超声23例单纯妊娠囊型，18例团块型，部分位于宫腔型6例，腹部超声中，部分位于宫腔型3例，16例团块型，22例单纯妊娠囊型。 结论 阴道彩色多普勒超声检查对CSP的诊断价值相比于腹部彩超明显要高，具有推广价值。 　　[Abstract] Objective To discuss the clinical significance of transvaginal color Doppler ultrasonography in detecting cesarean scar pregnancy. Methods 50 cases of patients with uterine incision scar pregnancy treated in our hospital from August 2012 to August 2015 were selected and were given abdominal and transvaginal color Doppler ultrasonography， the CSP diagnosis and sonogram classification of the two examination methods were observed. Results In the 50 cases of patients， the diagnostic accordance rate of transvaginal ultrasonography was 94.0% （47 cases）， missed diagnosis occurred to 3 cases， cervical pregnancy occurred to 2 cases， trophoblastic disease occurred to 1 case， the diagnostic accordance rate of abdominal ultrasonography was 82.0%（ 41 cases）， 3 cases were missed diagnosed， 3 cases were misdiagnosed， transvaginal ultrasonography showed that 23 cases belonged to simple gestational sac type， 18 cases belonged to lump type， portion belonging to uterine cavity type was in 6 cases， abdominal ultrasonography showed that portion belonging to uterine cavity type was in 3 cases， 16 cases belonged to lump type， 22 cases belonged to simple gestational sac type. Conclusion The value of transvaginal color Doppler ultrasonography in diagnosis of CSP is obviously higher than that of abdominal color Doppler ultrasonography， which is worth promotion. 　　[Key words] Uterine scar pregnancy； Transvaginal color Doppler ultrasonography； Clinical significance 　　子宫瘢痕妊娠（CSP）是指受精卵种植于既往剖宫产切口瘢痕处，其发病率近年来也逐渐随剖宫产术的广泛应用而不断上升。CSP早期诊断较为困难，常因误诊或漏诊而行清宫术或继续妊娠，可引起难以控制的大出血和子宫破裂，严重者需切除子宫[1-3]。因此，早期诊断CSP并及时制定有效的治疗方案尤为重要。该研究对2012年8月―2015年8月期间该院接收的