经腹和经阴道彩色多普勒超声在剖宫产后瘢痕妊娠诊疗中的应用分析.docVIP

经腹和经阴道彩色多普勒超声在剖宫产后瘢痕妊娠诊疗中的应用分析 　　【摘要】 目的：探讨经腹部彩色多普勒超声（TACD）和经阴道彩色多普勒超声（TVCD）在剖宫产后瘢痕妊娠（CSP）诊疗中的应用价值。方法：选择2010年3月-2014年12月本院收治的CSP患者38例作为研究组，选择同期剖宫产后瘢痕子宫正常妊娠的患者44例作对照组，回顾分析这38例CSP患者的超声影像特征及治疗经过，比较两组患者的超声指标及β-hCG水平，计算超声诊断准确率，并评估CSP患者按照妊娠囊与肌层关系分级采用治疗方案的可行性。结果：TACD和TVCD诊断正确率92.11%；研究组患者的肌层厚度及RI均小于对照组，比较差异有统计学意义（P0.05）；CSP声像图可归纳为3种类型，彩色多普勒血流显像（CDFI）表现妊娠囊或不均质团块周围有血流，流速增加。研究组按照妊娠囊与肌层分级指导治疗方案，均最终治愈。结论：TACD和TVCD诊断CSP具有较高的临床价值，可明确妊娠囊与肌层的分级关系及血供情况，为选择治疗方案提供依据从而提高治疗效果。 　　【关键词】 经阴道超声； 经腹部超声； 彩色多普勒； 剖宫产； 瘢痕妊娠 　　Application Analysis of Transabdominal and Transvaginal Color Doppler Ultrasound in the Diagnosis of Cesarean Scar Pregnancy/LU Wei-zhen.//Medical Innovation of China，2015，12（24）：146-149 　　【Abstract】 Objective：To explore the clinical value of trans-abdominal color doppler（TACD）and transvaginal color doppler（TVCD）in the diagnosis and treatment of cesarean scar pregnancy（CSP）.Method：38 patients with CSP in our hospital from March 2010 to December 2014 were selected as the research group，at the same time，44 cases of normal pregnancy with uterine scar after cesarean section were selected as the control group.The transvaginal ultrasound imaging of the 38 patients with CSP and their clinical treatments were retrospectively analyzed.The ultrasonic indexes and β-hCG levels were compared between the two groups.The accuracy rate of ultrasound diagnosis was calculated.The feasibility of making CSP treatment according to the relationship between the gestational sac and muscular layer was evaluated.Result：The correct diagnostic rate of TACD and TVCD for CSP was 92.11%.The muscular layer thickness and RI of the research group were less than those of the control group，the differences were statistically significant（P0.05）.The sonograms of CSP could be summarized as 3 types，the color doppler flow imaging（CDFI） displayed that there was blood flow around gestational sac or heterogeneous mass and the velocity was increased.38 patients in the research group were cured finally with the t