彩色超声在子宫疤痕妊娠诊治中的作用  

The Evaluation of Diagnoses and Management in Cesarean Scar Pregnancy with Color Doppler Ultrasound

作　　者：张小英[1] 彭艳丽[2] 陈涛[1] 朱亚利[1] 魏金铭[1] 王燕[1] 贾娟[1] 

机构地区：[1]北京市普仁医院超声科,北京100065 [2]北京市普仁医院妇科,北京100065

出　　处：《中国药物警戒》2011年第10期587-589,共3页Chinese Journal of Pharmacovigilance

基　　金：首都医学发展科研基金项目资助(2007-3;编号:11010340080989611A1001007)

摘　　要：目的评价彩色超声在疤痕妊娠诊治中的作用。方法使用经阴道超声诊断疤痕妊娠病例进行保留生育能力的保守治疗。记录子宫疤痕孕囊时间、超声结果、β-hCG、经阴道彩色超声血流情况和手术方式及经腹超声在术中监测情况。结果孕囊诊断时间约6周左右,剖腹产时间至疤痕妊娠时间为9～126月。经阴道超声诊断疤痕妊娠如下:孕囊大小0.8cm×0.4cm×0.5cm至2.2cm×2.1cm×1.0cm,有胎心,头臀径0.3cm至0.7cm,前壁肌层厚度0.5cm,血流显像丰富。对患者进行如下处理:子宫动脉栓塞后24小时在超声监测下行宫腔镜吸宫人流术2例,子宫动脉栓塞失败+系统MTX化疗,经阴道超声检查孕囊仍存活,患者自动出院,后随访得知宫腔镜下行吸宫人流术,证实疤痕妊娠1例。结论经阴道超声是子宫疤痕妊娠早期诊断非常有用手段,在经腹超声术中监测,明显缩短手术时间,减少盲目性,保证了手术安全。objecive To evaluate our experience and diagnosis of cesarean scar pregnancy（CSP） with color doppler ultrasound. Methods From March 2006 to June 2010, 3 cases of cesarean scar pregnancy were diagnosed using color doppler sonography and treated conservatively to preserve fertility. Gastational age, sonographic findings, β-human chorionic gonadotropin（β-hCG） levels, flow profiles of transvaginal color Doppler ultrasound, and trasabdominal sonography during treatment were recorded. Results The gastational sac（GS） ages were diagnosed for about 6 weeks. The time interval from the Cesarean section to the diagnosis of Cesarean scar pregnancy was from 9 months to 126 months. Embryonic period diagnosed by color doppler sonography were as follow： the sizes of GS ranged from 0.8cm×0.4cm×0.5cm to 2.2cm×2.1cm×1.0cm, all with cardiac activity, the crown-rump length ranged from 0.3cm to 0.7cm, the anterior myometrial thickness to the csp were measured 0.5cm with rich color flow show. The patients were treated as follow： ultrasound-guided dilation and curettage under hysteroscopy within 24 hours following uterine artery embolization（n=2）, the failure of uterine artery embolization and systemic methotrexate（MTX） injection, the vial GS validated by transvaginal ultrasound, then getting out and dilation and curettage of the csp under hysteroscopy by following-up（n=1）. Conclusion Transvaginal ultrasound plays an important and useful role in the early diagnosis of the CSP. During operation under the abdominal ultrasound online screening, it is obvious for the shorteness of opareative time, the decrease of operator＇s blindness and the safeguard of operative security to dilate and currette.

关 键 词：疤痕妊娠 彩色超声 

分 类 号：R714.221[医药卫生—妇产科学]