摘要
目的分析剖宫产术后不同部位血肿超声表现及临床特点,探讨超声检查对剖宫术后血肿诊治的临床价值。方法回顾性分析超声检出的16例剖宫产术后不同部位血肿患者超声声像图及临床资料。所有患者均经手术或临床随访观察证实。结果本组16例剖宫产术后血肿患者中,阔韧带或合并腹膜后血肿4例,超声声像图表现为子宫一侧不均质中等回声包块,合并腹膜后血肿时可向上延续至肝肾间隙处,均需急诊手术;子宫切口处血肿4例,超声声像图表现为子宫下段切口区域不均质中等回声包块,多凸向膀胱,均保守治疗,其中1例超声引导下抽吸治疗;腹直肌周围血肿7例,超声声像图表现为腹直肌浅方、内部、深方长圆形或梭形不均质中低回声包块,可单独存在亦可同时存在,均保守治疗,其中1例超声引导下抽吸治疗;皮下血肿1例,超声声像图表现为皮下脂肪层内无回声,其内可探及细点状回声,保守治疗。结论超声检查对剖宫产术后血肿患者的诊断具有重要意义,可提示血肿部位、大小、内部回声等,以指导临床选择治疗方案。
Objective To analyze the clinical significance of ultrasound examination in the diagnosis of hematoma after cesarean section.Methods Ultrasound images of 16 cases with different locations of hematomas after cesarean section were retrospectively analyzed.Results The ultrasound images of 4 cases with broad ligament hematomas （complicated with or without retroperitoneal space hematomas） were manifested as a complex mass on one side of uterus. If a retroperitoneal space hematoma was present,the complex mass extended towards the inter-space between the liver and kidney. This type of hematoma required immediate surgery. The ultrasound images of 4 cases with hematoma at the uterus incision were manifested as complex masses in the segment of incision and majority of the masses were convex to the bladder. Usually, conservative treatment was performed for this type of hematoma. For example, sucking treatment was performed in one case under the guidance of ultrasound. The ultrasound images of 7 cases with hematoma surrounding the rectus abdominis were manifested as complex long circular or spindle-shaped masses on the superficial, inside or deep layers of the rectus abdominis. The mass can be single or multiple masses existed simultaneously. Conservative treatment was performed for this type of hematoma. For example, sucking treatment was performed in one case under the guidance of ultrasound. The ultrasound images of one case of subcutaneous hematoma were manifested as point-like echo inside the anechoic area and conservative treatment was applied to this case.Conclusions Ultrasound examination can indicate the location, size and internal echoes of hematomas after cesarean section. In addition, it can provide treatment strategies for patients with different locations of hematomas.
出处
《中华医学超声杂志（电子版）》
2012年第11期17-21,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
剖宫产术
血肿
超声检查
Cesarean section
Hematoma
Ultrasonography
