宫角部妊娠的超声诊断特点与误诊分析.docVIP

宫角部妊娠的超声诊断特点与误诊分析 　　[摘要]目的 探讨宫角部妊娠的超声图像特征，分析常见的误诊原因。 方法 回顾性分析我院2011年1月～2015年12月收治并经病理证实的37例宫角部妊娠患者的超声表现，比较病理检查结果与超声诊断结果的符合率。 结果 37例宫角部妊娠患者经腹或经阴道超声检查定位诊断正确符合率81%（30/37），3例笼统诊断为异位妊娠，3例误诊为输卵管间质部妊娠，1例误诊为宫角部葡萄胎。 结论 经腹或经阴道超声技术对宫角妊娠的诊断提供一定依据，仔细观察妊娠囊或包块是否位于宫角部位，与内膜是否相连及周围肌层是否包绕，肌层厚度，能够提高宫角部妊娠的超声诊断准确率。 　　[关键词]宫角部妊娠；超声诊断；误诊；彩色多普勒超声诊断 　　[中图分类号] R445.1 [文献标识码] B [文章编号] 2095-0616（2016）09-171-03 　　[Abstract] Objective To explore and discuss the ultrasonic imaging characteristics of uterine cornual pregnancy， and to analyze the common misdiagnosis reasons. Methods The ultrasonic appearance of 37 uterine cornual pregnancy patients with pathologically-proved from January 2011 to December 2015 in my hospital were retrospectively analyzed. The coincidence rate of pathological examination results and ultrasonic diagnosis results were compared. Results For 37 cases of uterine cornual pregnancy， the correct coincidence rate of ultrasound examination and localization diagnosis by abdominal or transvaginal was 81% （30/37）， 3 cases were generally diagnosed as ectopic pregnancy， 3 cases were misdiagnosed as tubal interstitial pregnancy， and 1 cases were misdiagnosed as cystic mole of cornua uterin. Conclusion The ultrasonic technique by abdominal or transvaginal could provide certain basis for the diagnosis of uterine cornual pregnancy. Careful observation of whether the gestational sac or abdominal mass was located in the uterine horn， whether connecting to the inner membrane and being surrounded by myometrium around and thickness of muscular layer， which could improve the accuracy rate of ultrasound diagnosis on uterine cornual pregnancy. 　　[Key words] Uterine cornual pregnancy； Ultrasound diagnosis； Misdiagnosis； Color doppler ultrasound diagnosis 　　宫角部妊娠临床较少见，发生率低，在所有异位妊娠中仅占3%[1-2]，该疾病无特异性临床表现，诊断较为困难，造成实际诊断过程中较高的误诊率[3-4]，若发现不及时或者诊断错误及误诊极易造成患者宫角破裂，进而发生失血性休克，严重时可危及患者生命[5]。本研究回顾性分析我院2011年1月～2015年12月收治的经病理证实的37例宫角妊娠患者的超声表现，旨在提高宫角部妊娠超声诊断准确性，以期为临床医生提供有力的诊疗依据。 　　1 资料与方法 　　1.1 一般资料