剖宫产切口瘢痕妊娠的超声表现及影响因素分析  

Analysis of the ultrasonic findings and influencing factors of cesarean scar pregnancy

作　　者：张茂春[1] 王琦[1] 张红薇[1] 郭媛媛[1] 陈娇[1] 周洪贵[1] 

机构地区：[1]川北医学院附属医院妇产超声科,四川南充637000

出　　处：《川北医学院学报》2017年第1期42-45,共4页Journal of North Sichuan Medical College

基　　金：四川省教育厅课题(16ZB0226)

摘　　要：目的:总结剖宫产切口瘢痕妊娠超声图像特征,分析诊断准确性影响因素。方法:选择接受超声检查且经手术病理证实为剖宫产切口妊娠的44例患者,收集所有患者的临床资料与影像学资料,分析剖宫产切口瘢痕妊娠的超声特点及影响因素。结果:本组44例患者,经阴道超声检出剖宫产切口瘢痕37例,符合率为84.09%,误诊7例,占15.91%。分为单纯孕囊型与不均质包块型,其中单纯孕囊型27例,检出20例,检出率为74.07%;不均质包块型17例,全部检出;阴道超声共误诊7例,均为单纯孕囊型,患者无特异性症状,4例误诊为宫内早孕,2例误诊为难免流产,1例误诊为宫颈妊娠。超声显示孕囊距剖宫产切口瘢痕超过2.5 mm,认为孕囊距剖宫产切口瘢痕距离可能为影响超声诊断准确率的相关因素。结论:采用经阴道超声诊断剖宫产切口瘢痕妊娠,操作简单,无创,诊断准确率高,而孕囊距剖宫产切口瘢痕距离则为影响超声诊断准确性的相关因素。Objective： To summarize the ultrasonic findings of cesarean scar pregnancy and to analyze the factors affecting the diagnostic accuracy. Methods： 44 cases of patients who underwent uhrasonography and were confirmed with cesarean scar pregnancy by surgery and pathology in the hospital were studied. The clinical data and imaging data of all patients were collected to analyzed the ultrasonic characteristics and the influencing factors for cesarean scar pregnancy. Results： Among the 44 patients,there were 37 cases with cesarean scar pregnancy detected by transvaginal ultrasound and the coincidence rate was 84. 09%. 7 cases were misdiagnosed,accounting for 15. 91%. The findings were divided into simplex gestational sac type and inhomogeneous mass type,including 27 cases of simplex gestational sac type of whom 20 cases were detected and the detection rate was 74. 07%. 17 cases of inhomogeneous massive type were detected. A total of 7 cases were misdiagnosed by transvaginal ultrasound. All were simplex gestational sac type,without specific symptoms. There were 4 cases misdiagnosed with inter-uterus early pregnancy,2 cases with inevitable abortion and 1 cases with cervical pregnancy. Ultrasound showed that the distance between gestational sacs and cesarean scar was longer than 2. 5mm,indicating that the distance from the gestational sacs to cesarean incision scar may be the related factors influencing the diagnostic accuracy of ultrasound.Conclusions： To adopt transvaginal ultrasound in the diagnosis of cesarean scar pregnancy is easy to operate and noninvasive. The diagnostic accuracy is high and the distance from the gestational sacs to cesarean incision scar is the related factors influencing the diagnostic accuracy of ultrasound.

关 键 词：瘢痕妊娠 剖宫产 超声 影响因素 

分 类 号：R714.22[医药卫生—妇产科学] R445.1[医药卫生—临床医学]