超声检查在瘢痕子宫妊娠分娩方式选择中的应用价值.docxVIP

超声检查在瘢痕子宫妊娠分娩方式选择中的应用价值 　　[摘要]目的探讨超声检查在瘢痕子宫妊娠分娩方式选择中的应用价值。方法选取我中心于2017年1月～2018年12月收治的60例瘢痕子宫妊娠产妇作为研究对象，根据超声检查结果的不同将其分为ⅰ、ⅱ、ⅲ、ⅳ级瘢痕组，分别为20、20、10、10例。选择我中心同期60例正常分娩产妇作为对照组。比较各组的分娩方式、手术相关指标、术后并发症发生情况、新生儿窒息发生情况及子宫前壁下段厚度。结果ⅱ、ⅲ、ⅳ级瘢痕组的剖宫产率高于对照组及ⅰ级瘢痕组，差异有统计学意义（p0.05）。ⅱ、ⅲ、ⅳ级瘢痕组产妇的术中出血量和24h产后出血量均多于对照组及ⅰ级瘢痕组，手术时间长于对照组及ⅰ级瘢痕组，不全子宫破裂发生率高于对照组及ⅰ级瘢痕组，切口愈合不良发生率高于对照组，差异有统计学意义（p0.05）。ⅲ、ⅳ級瘢痕组新生儿窒息总发生率高于其他组新生儿，差异有统计学意义（p0.05）。子宫前壁下段厚度比较，ⅳ级瘢痕组ⅲ级瘢痕组ⅱ级瘢痕组ⅰ级瘢痕组对照组，差异均有统计学意义（p0.05）。结论超声检查技术在瘢痕子宫妊娠产妇分娩方式的选择中具有指导意义，值得应用推广。 　　[关键词]瘢痕子宫妊娠;分娩方式;超声检查 　　[中图分类号]r000[文献标识码]a[文章编号]1674-4721（2020）1（c）-0148-04 　　[abstract]objectivetoexploretheapplicationvalueofultrasoundexaminationinthechoiceofdeliverymodeforscaruteruspregnancy.methodsatotalof60casesofpregnantwomenwithscaruterusadmittedtoourcenterfromjanuary2017todecember2018wereselectedasresearchobjects.accordingtodifferentultrasonicexaminationresults，theyweredividedintogradeⅰ，ⅱ，ⅲandⅳscargroups，therewere20，20，10，10casesrespectively.and60normalparturientsinthesameperiodadmittedtoourcenterwereselectedasthecontrolgroup.thedeliverymethods，operation-relatedindexes，postoperativecomplications，neonatalasphyxiaandthethicknessoftheloweruterineforearmwerecomparedamongthegroups.resultsthecesareansectionrateofgradeⅱ，ⅲandⅳscargroupwerehigherthanthatofthecontrolgroupandgradeⅰscargroup，thedifferenceswerestatisticallysignificant（p0.05）.theintraoperativebloodlossand24hpostpartumbloodlossofparturientsingradeⅱ，ⅲandⅳscargroupwereallhigherthanthoseinthecontrolgroupandgradeⅰscargroup，theoperationtimewerelongerthanthatinthecontrolgroupandgradeⅰscargroup，theincidenceofincompleteuterinerupturewerehigherthanthatinthecontrolgroupandgradeⅰscargroup，andtheincidenceofpoorincisionhealingwerehigherthanthatinthecontrolgroup，withstatisticallysignificantdifferences（p0.05）.thetotalincidenceofneonatalasphyxiaingradeⅲandⅳscargroupwerehigherthanthatinothergroups，andthedifferenceswerestatisticallysignificant（p0.05）.comparedwiththethicknessofthelowersegmentoftheanteriorwallofuteru