超声对子宫瘢痕妊娠的诊断与临床治疗中的价值  

Clinical value of color Doppler flow imaging in diagnosis and treatment of cesarean scar pregnancy

作　　者：冯清华[1] 刘长珠[1] 王俊东[1] 李海玲[1] 

机构地区：[1]广州市第八人民医院超声科,510650

出　　处：《国际医药卫生导报》2017年第9期1429-1432,共4页International Medicine and Health Guidance News

摘　　要：目的探讨子宫瘢痕妊娠彩色多普勒超声的特点及其临床治疗价值。方法选取本院2011年7月至2016年6月期间收治的剖宫产术后子宫瘢痕妊娠的患者36例，对其彩色多普勒超声图像及临床治疗方法进行回顾性的分析和总结。结果36例瘢痕妊娠患者中，根据超声图像提示孕囊的生长方向及子宫前壁孕囊与膀胱间子宫肌层的厚度分为3型，Ⅰ型15例，Ⅱ型11例，Ⅲ型10例，超声诊断正确30例，正确率83.3%，误诊6例，其中2例误诊为宫内早孕难免流产，2例误诊滋养细胞疾病，1例误诊宫内早孕，1例误诊宫颈妊娠。13例Ⅰ型和6例Ⅱ型患者采用了经腹超声监测下清宫术治疗；4例Ⅱ型及2例Ⅲ型患者采用了经腹超声引导下病灶局部注射甲氨蝶呤治疗。结论彩色多普勒超声对子宫瘢痕妊娠能做出较准确的定位诊断，帮助临床在制定治疗方案、指导治疗及随访中具有非常重要的指导作用。ObjectiveTo evaluate the diagnostic and treatment value of color Doppler flow imaging for cesarean scar pregnancy （CSP）.MethodsFrom July 2011 to June 2016, the CDFI manifestations and treatment of 36 cases of CSP from our hospital were retrospectively analyzed and summarized.ResultsAccording to the progesterone sac of growth direction and the myometrium thickness between progesterone sac and bladder, the 36 cases were classified into three types： 15 cases were type I, 11 typeⅡ, and 10 type Ⅲ. Among them, 30 patients （83.3%） were diagnosed accurately by ultrasonic imaging and 6 cases, including intrauterine pregnancy inevitable abortion （2 cases）, malignant trophoblastic disease （2 cases）, early intrauterine pregnancy （1 case）, and cervix pregnancy（1 case）, were misdiagnosed. Thirteen patients of type I and six patients of type Ⅱ underwent suction curettage under sonographic guidance; Four patients type Ⅱ and two patients of type Ⅲ received intra-amniotic administration of MTX under sonographic guidance.ConclusionColor Doppler ultrasound can precisely diagnose and localize cesarean scar pregnancy and plays an important role in guiding the conservative treatment schedule and evaluating the therapeutic effect and following-up of these patients.

关 键 词：子宫瘢痕妊娠 彩色多普勒超声 诊断 治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]