胎盘早剥的超声表现及临床价值.docVIP

胎盘早剥的超声表现及临床价值 汪丽秀 (浙江大学医学院附属妇产科医院超声科浙江杭州310006) 【摘要】目的：探讨胎盘早剥超声声像图特点并总结临床价值。方法：回 顾性分析了 2010年1月?2015年1月我院手术及超声均确诊收治的胎盘早剥58 例。结果：超声诊断胎盘早剥58例，11例胎盘与宫壁间暗区。10例胎盘与宫壁 间肿物。28例胎盘边缘讼形索状肿物，或者胎盘与宫壁间凸向羊膜腔肿物。6 例胎盘异常增厚。3例羊水区内见散在漂浮小光点。结论：超声检查在临床评价 胎盘早剥只有重要临床价值，对降低母婴围产期病死率只有重要临床价值。 【关键词】胎盘早剥；超声诊断 【中图分类号】R714 【文献标识码】A 【文章编号】2095-1752 (2015) 27-0112-04 Ultrasound Characteristics and Significance in Abruptio Placentae Wang Lixiu Department of Ultrasound ,Obstetrics and Gynecology hospital affiliated to zhejiang university,Zhejiang Hangzhou 310006. [Abstract lObjective To explore the feature of the ultrasonographic appearances of placental abrupture and possible reasons of missed diagnosis. Methods 58 cases of atypical placental abrupture were scanned by transabdominal color Doppler ultrasonography to observe the echo of retroplacental, introplacental region, and the thickness of the placenta. Results 58 cases of placental abruption are discovered in the ultrasonic diagnosis, as well as: Eleven cases of anechoic retroplacental region; Ten cases of the mass between the placenta and palace wall; Twenty Eight cases of placental edge long funicular neoplasm, or between membranes and palace wall protruding into the amniotic cavity leaded to a fluid or low echo; Six cases of abnormal thickening of the placenta. Three cases of amniotic fluid zone scattering in the floating small points of light .Conclusions Ultrasound has important clinical value in the clinical evaluation of placental abruption ,has important clinical value to reduce maternal and infant perinatal mortality. 【Key words】 Placental abruption;Ultrasonic diagnosis 妊娠20周后或分娩期，正常位置的胎盘在胎儿娩出前部分或全部从子宫壁 剥离，称胎盘早期剥离，即胎盘早剥。部分胎盘早剥患者临床表现典型，易被发 现识别，多不需超声检查协助诊断。而不典型胎盘早剥往往因剥离部位、范围, 不同病理时期，患者病情复杂多样，变化快，或临床表现差异大，超声图像不典 型等，易与子宫收缩，子宫腺肌病、胎盘病变等声像图表现混淆，发生漏误诊。 本文对58例胎盘早剥患者超声声像图特点及漏诊原因分析。 资料与方法 1.1研究对象 2013年1月至2015年1月以停经20周后阴道出血、阴道流液等急诊来我 院就诊的超声及临床均确诊胎盘早剥患者58例，年龄20?40岁，术前腹部彩色 多普勒超声检查提示胎盘与子宫壁之间异常冋声、胎盘冋声异常58例。 1.2仪器与方法 采用GE Voluson 730 Expert、GE Iogic7彩