彩色多普勒超声在子宫动脉栓塞术治疗子宫瘢痕妊娠疗效监测中的应用  

Application of color Doppler ultrasound in monitoring the outcome of uterine artery embolization for cesarean scar pregnancy

作　　者：熊希[1] 高春燕[1] 孙秋蕾[1] 颜苹[1] 

机构地区：[1]第三军医大学新桥医院妇产科,重庆400037

出　　处：《中国介入影像与治疗学》2015年第10期606-610,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨彩色多普勒超声在子宫动脉栓塞术（UAE）治疗子宫瘢痕妊娠（CSP）疗效监测与评价中的应用价值。方法回顾性分析96例CSP患者UAE治疗前及治疗后的超声表现及相关临床资料,并进行统计学分析。结果 96例CSP患者中,孕囊型58例,团块型38例。孕囊型CSP患者UAE并清宫后孕囊均被清除。团块型CSP患者UAE并清宫后24-48h团块直径较UAE术前及UAE术后24-48h减小（P均〈0.001）。孕囊型与团块型CSP患者间,UAE术前、UAE术后24-48h及UAE并清宫后24-48h病灶周边血流信号分级差异均无统计学意义（P均〉0.05）。两种类型CSP患者UAE术后24-48h、UAE并清宫后24-48h病灶周边血流信号分级均较UAE术前明显减低（P均〈0.001）。孕囊型与团块型CSP患者间,UAE术前及UAE术后24-48h子宫瘢痕厚度差异均无统计学意义（P均〉0.05）。UAE并清宫后24-48h孕囊型CSP患者子宫瘢痕厚度高于团块型（P〈0.001）。孕囊型CSP患者UAE并清宫后24-48h子宫瘢痕厚度高于UAE术前及UAE术后24-48h（P均〈0.001）。团块型CSP患者UAE并清宫后24-48h子宫瘢痕厚度高于UAE术前（P=0.037）,与UAE术后24-48h差异无统计学意义（P=0.112）。孕囊型CSP患者术中出血量、住院时间、血清人绒毛膜促性腺激素（β-HCG）降至正常的时间及术后阴道流血时间均少于团块型（P均〈0.001）。结论通过彩色多普勒超声可有效监测UAE治疗CSP的疗效,UAE对不同类型CSP的疗效有所不同,孕囊型CSP患者疗效优于团块型。Objective To investigate the Application value of color Doppler ultrasound in monitoring the outcome of uterine artery embolization（UAE）for cesarean scar pregnancy（CSP）.Clinical and ultrasound data of 96 patients with CSP were retrospectively analyzed.The statistical analysis was performed.Methods Among 96 patients,there were 58 cases of gestational-sac type CSP（gestational-sac group）and 38 cases of mass type CSP（mass group）.In gestational-sac group,all the gestation saces were clear away after UAE combined with curettage.In mass group,the diameter of lesion was decreased after UAE combined with curettage than that before and 24—48 hours after UAE（both P〈0.001）,respectively.There was no statistical difference of peripheral blood flow signal grade between gestational-sac and mass groups before UAE,24—48 hours after UAE or UAE combined with curettage（all P〉0.05）.Compared with the peripheral blood flow signal grade before UAE,the grades were decreased 24—48 hours after UAE or UAE combined with curettage（both P〈0.001）in the two groups.No statistical difference of the thickness of uterine scar was found between gestational-sac and mass groups before and 24—48 hours after UAE（both P〉0.05）.The thickness of uterine scar in gestational-sac group was higher than that in mass group 24—48 hours after UAE combined with curettage（P〈0.001）.In gestational-sac group,the thickness of uterine scar 24—48 hours after UAE combined with curettage was separately higher than that before and 24—48 hours after UAE（both P〈0.001）.In mass group,the thickness of uterine scar 24—48 hours after UAE combined with curettage was higher than that before UAE（P=0.037）.There was no statistical difference between the thickness of uterine scar 24—48 hours after UAE and 24—48 hours after UAE combined with curettage（P=0.112）.The blood loss during operation,time of hospitalization,time of serum human chorionic gonadotropin（β-HCG）return to normal and time of postoperative va

关 键 词：超声检查 妊娠 异位 栓塞 治疗性 

分 类 号：R445.1[医药卫生—影像医学与核医学]