摘要
目的评价经阴道联合经腹超声在瘢痕妊娠诊断中的临床应用价值。方法对经手术和病理证实的108例瘢痕妊娠进行回顾性分析,超声提示孕囊大小、位置、孕囊与宫颈内口及子宫瘢痕的关系,以及子宫下段瘢痕处子宫肌层厚度,以便临床医生选择治疗方案。分析总结比较经阴道及经腹超声两种方法单独使用及联合使用的诊断符合率。结果108例瘢痕妊娠中孕囊型98例(90.74%),其中孕囊部分位于宫腔有33例,混合包块型10例(9.26%)。单独经阴道超声检查诊断98例(90.74%),单独经腹超声检查诊断84例(77.78%),联合使用经阴道经腹超声检查诊断105例(97.22%)。联合使用经阴道经腹超声检查诊断符合率明显高于单独经腹部和经阴道超声检查,经阴道超声检查诊断符合率高于经腹部超声检查,差异有统计学意义(P<0.05)。结论联合使用经阴道经腹超声检查是一种有效的早期诊断剖宫产瘢痕妊娠的方法。经阴道超声观察瘢痕妊娠的回声结构、血流情况、肌壁厚度等均优于经腹超声,经腹超声在整体观察瘢痕妊娠位置、与子宫下段的关系及子宫体、宫颈情况时更有优势,两者联合使用可获取更全面清晰的超声图像。
Objective To evaluate the clinical value of transvaginal ultrasound combined with transahdominal ultrasound in the diagnosis of cesarean scar pregnancy. Methods The data of 108 cases confirmed as cesarean scar pregnancy by surgery and pathology were analyzed retrospectively. The information should be displayed by ultrasound including the size and location of the gestational sac, the relation of the gestational sac with orifieium intemum uteri and uterine scar, and myometrial thickness of the scar in the lower segment, so that the clinicians could choose the therapeutic regimen. The diagnostic accordance rate was compared among transvaginal ultrasound, transabdominal ultrasound and the combination of the two methods. Results Of 108 cases with cesarean scar pregnancy, gestational sac type was found in 98 cases（90.74% ） and mixed mass type in 10 cases（9.26% ）. The gestational sacs of 33 cases were located in uterine cavity. A total of 98 eases（90.74% ）, 84 eases（77.78% ） and 105 eases（97.22% ） were diagnosed by transvaginal ultrasound, transabdominal ultrasound and the combination of the two methods respectively. The diagnostic accordance rate of the combination examination was higher than that of transvaginal ultrasound or transabdomi- nal ultrasound, and the rate of transvaginal uhrasound was higher than that of transabdominal ultrasound （P 〈 0.05）. Conclusion Transvaginal ultrasound combined with transabdominal ultrasound is an effective method for the early diagnosis of cesarean scar pregnancy. Observation about acoustic echo structure, blood flow condition and myometrial thickness of the patients with cesarean scar pregnancy by transvaginal ultrasound is superior to transabdominal ultrasound. Transabdominal ultrasound has a superiority in the whole observation about gestational sac location, the relationship of gestational sac with lower uterine segment, condition of uterine body and cervix. The combination of the two methods can obtain more comprehensive and clear ultrasound images.
出处
《微创医学》
2018年第1期62-64,共3页
Journal of Minimally Invasive Medicine
基金
广西医药卫生科研课题(编号:Z2015266)
关键词
瘢痕妊娠诊断
经阴道超声
经腹部超声
联合应用
Diagnosis of cesarean scar pregnancy
Transvaginal ultrasound
Transabdominal ultrasound
Combined application
