摘要
目的:探究产前超声征象评分在不同前置胎盘(PP)诊断中的应用价值。方法:抽取医院定期产检及经剖宫产分娩的100例PP孕产妇,根据剖宫产术中病理证实合并胎盘植入情况将其分为植入组(48例)和未植入组(52例)。两组PP孕妇产前均接受超声检查,建立产前超声征象评分表,比较两组超声征象评分,对两组不同PP诊断效能采用受试者工作特征(ROC)曲线下面积评定,并与剖宫产术后诊断的金标准进行对比,统计超声征象评分对是否合并胎盘植入PP的诊断效能。结果:植入组孕产妇中,胎盘增厚程度≥5 cm、胎盘后部间隙大部消失、胎盘内部回声不均匀、子宫浆膜层-膀胱交界面血管丰富、可见局灶性或广泛性胎盘实质内腔隙血流者占比显著高于未植入组(x^2=3.87,x^2=4.69,x^2=10.17,x^2=4.76,x^2=4.69;P<0.05)。产前超声征象评分为11分;两组的总评分ROC曲线下面积为0.926,置信区间(95%CI)1.022～2.517,根据约登指数最大时确定最佳分界点为3分,产前超声征象评分诊断合并胎盘植入PP的灵敏度、特异度和准确率分别为89.58%、96.15%和93.00%。结论:产前超声征象评分对不同PP诊断有较高的效能,尤其可为合并胎盘植入或胎盘穿透的临床诊治提供客观依据。
Objective:To explore the application value of antenatal ultrasonographic sign score in the diagnosis of different placenta previa(PP).Methods:100 pregnant women with PP who received regular maternity examination and cesarean section were enrolled in this study.And they were divided into implantation group(48 cases)and non-implantation group(52 cases)according to the synthetic judgment of pathological confirmation and placenta implantation during cesarean section.The pregnant women with PP of two groups underwent prenatal ultrasound examination,and their antenatal ultrasonic sign score tables were established.And the ultrasonic sign score of two groups were compared,and areas under receiver operator curve(ROC)were used to judge diagnostic efficacy of different PP between two groups,and these areas were compared with the diagnostic gold standard post cesarean section.And through analyzed the diagnostic efficacy of ultrasonic sign score to judge whether combined with placenta implantation of pregnant women with PP.Results:And the proportions of pregnant women whose increased thickness of placenta was higher than or equal to 5 cm,whose most posterior space of placent disappeared,whose internal echo of placenta was inhomogeneous,who had rich blood vessels at interface of uterine serosa-bladder and who had focal or extensive placenta parenchyma lacunar blood flow of implantation group were significantly higher than those in the non-implantation group(x2=3.87,x2=4.69,x2=10.17,x2=4.76,x2=4.69,P<0.05).The score of antenatal ultrasonic signs was 11 points,and the area under ROC of total score of two groups was 0.926 which confidence interval(95%CI)was between 1.022 and 2.517.According to the maximum Youden index,the optimal cut-off point was 3 points.At the moment,the sensitivity,specificity and accuracy of antenatal ultrasonic sign score in diagnosing PP with placenta implantation were 89.58%,96.15%and 93.00%,respectively.Conclusion:The diagnostic efficiency of antenatal ultrasonic sign score is higher for different PP,an
作者
陈静
李媛媛
CHEN Jing;LI Yuan-yuan(Department of Ultrasonic Medicine,Affiliated Hospital of Chengdu University,Chengdu 610081,China.)
出处
《中国医学装备》
2018年第12期97-100,共4页
China Medical Equipment
关键词
产前
超声征象评分
前置胎盘
胎盘植入
诊断
Antenatal
Ultrasonographic sign score
Placenta previa
Placenta implantation
Diagnosis
