剖宫产切口瘢痕妊娠的声像图特征及临床分析  

Ultrasonic features and clinical analysis of cesarean scar pregnancy

作　　者：张爱青[1] 刘朝晖[1] 赵文秋[1] 叶振亚[1] 

机构地区：[1]北京大学第三医院妇产科超声室,北京市100083

出　　处：《临床超声医学杂志》2008年第9期622-624,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨经阴道彩色多普勒超声在剖宫产切口瘢痕妊娠诊治中的价值。方法分析12例剖宫产切口瘢痕妊娠患者的声像图特征、临床转归及手术病理结果。结果声像图表现为孕囊型9例和混合回声型3例。其中孕囊型分为3型:①3例孕囊位于切口表面,血流不丰富;②4例孕囊陷入切口内,血流丰富;③2例孕囊自切口处向膀胱方向突起,血流丰富。保守治疗过程中,超声检查显示病灶逐渐缩小,血流逐渐减少到消失,血HCG逐渐降低到正常。结论经阴道彩色多普勒超声检查可以对剖宫产术后切口瘢痕妊娠及时、准确作出诊断;根据声像图特征进行分型,有助于临床选择恰当的治疗方案,并评估疗效。Objective To explore the application value of transvaginal color Doppler ultrasound in the diagnosis of cesarean scar pregnancy. Methods The ultrasonic features, clinical treatment and pathologic results of 12 cases of cesarean sear pregnancy were reviewed retrospectively. Results The sonographic appearance showed 9 cases were gestational sac - type and 3 cases were mixed mass - type. The gestational sac - type were further divided into three types. In 3 cases, the gestational sac was located at the surface of incision, the blood flow was not plentiful; in 4 cases,the gestational sac was embolismed into the incision, the blood flow was plentiful; in 2 cases, the gestational sac protruded to the surface of bladder, the blood flow was plentiful. During expectant treatment, ultrasonography shows focus of infection was shrinked gradually and blood flow disappeared, blood HCG was decreased to normal level. Conclusion Transvaginal color Doppler ultrasound can diagnose cesarean sear pregnancy promptly and accurately, proportionate treatment would be selected according to the type of cosarean sear pregnancy, and also can evaluate the therapeutic effect.

关 键 词：超声检查 多普勒 彩色 经阴道 剖宫产术 切口瘢痕 妊娠 

分 类 号：R719.8[医药卫生—妇产科学] R714.22[医药卫生—临床医学]