超声微泡造影评估瘢痕子宫妊娠引产风险的价值研究  

The Value of Ultrasound Microbubbles in Assessing the Risk of Induced Labor with Scarred Uterus

作　　者：潘颜 常青[1] 李锐[1] 宋永红[1] 陈诚[1] 马永毅[1] 严小丽[1] 王丹[1] 胡华[1] 

机构地区：[1]第三军医大学第一附属医院,重庆400038

出　　处：《实用妇产科杂志》2015年第8期599-602,共4页Journal of Practical Obstetrics and Gynecology

基　　金：重庆市科技攻关项目(编号:cstc2012gg-yyjs10056)

摘　　要：目的:探讨介入超声微泡造影检查在评估瘢痕子宫妊娠引产风险的价值,以便指导临床安全有效地引产。方法:采用回顾性病例对照研究方法,以我院2008年至2014年期间住院引产的瘢痕子宫孕妇70例为研究对象,根据不同检查方式分为介入超声微泡造影检查组(n=20)和普通超声检查组(n=50),比较两组检出子宫瘢痕缺损、前置胎盘、子宫切口妊娠情况及出现产后出血、子宫破裂、子宫切除的情况。结果:微泡造影检查组检出子宫切口妊娠5例,前置胎盘3例,子宫瘢痕缺损面积直径大于5 mm者4例;普通超声检查组仅查出前置胎盘患者4例,两种检查方式,对于子宫切口妊娠和子宫瘢痕缺损的检出率差异有统计学意义(P<0.05)。对检出的高危孕妇,采取预防性措施后引产。微泡造影检查组产后出血1例;普通超声检查组产后出血4例、子宫破裂2例、子宫切除2例;微泡造影检查组产后并发症发生率小于普通超声检查组,但差异无统计学意义(5.0%vs14.0%,P>0.05)。结论:介入超声微泡造影对子宫切口妊娠、子宫瘢痕缺损的评估价值优于普通超声检查,通过明确胎盘与瘢痕关系及瘢痕缺损面积,有助于指导临床安全有效地引产。Objective： To assess the value of ultrasound microbubbles（ UM） in evaluating the induced labor with scarred uterus for guiding the choice of safe method of induce labor. Methods： With a retrospective case-eontrol study,70 hospitalized patients of induced labor with scarred uterus were selected from department of obstetrics and gynecology,the first Affiliated Hospital of Third Military University during 2008-2014 year. All cases were divided in two groups by different examination method： 20 cases by ultrasound microbubbles（ ultrasound microbubbles group）; 50 cases by routine ultrasound（ routine ultrasound group）. The width of uterine scar defect,the relationship of placenta and scar,postpartum hemorrhage ratio,placental retention ratio,uterine rupture ratio and hysterectomy ratio were compared between these two groups. Results： 5 cases of cesarean scar pregnancy,3 cases of placenta previa and 4 cases with the width of uterine scar defect wider than 5 mm were checked out by ultrasound microbubbles,3 cases of placenta previa were checked out by routine ultrasound. There was significant difference between two groups in cesarean scar pregnancy and the width of uterine scar defect（ P〈0. 05）. Pregnant women with above high risk factors were adopted preventive measures before induced labor. Overall,1 woman had postpartum hemorrhage in group 1; 4 women had postpartum hemorrhage,2 had uterine rupture and 1 had hysterectomy in group 2. Although the outcomes of group 1 was better than group 2,there was no significant difference between the two groups（ 5. 0% vs 14. 0%,P〈0. 05）. Conclusions： Ultrasound microbubbles is better in examing the width of uterine scar defect and the relationship of placenta and scar than routine ultrasound,so it is helpful to evaluate the risk of induced labor with scarred uterus in order to avoid catastrophic complications.

关 键 词：微泡造影 瘢痕子宫 引产风险 

分 类 号：R719.3[医药卫生—妇产科学]