超声检测孕晚期子宫前壁下段厚度在预测瘢痕子宫术中破裂风险中的应用价值  

Application Value of Ultrasonic Testing of Lower Uterine Segment Thickness during Late Pregnancy in Predicting Uterine Rupture in Scarred Uterus Surgery

作　　者：邓华东[1] 邹凯华[1] 许敬华[1] 施红卫[1] 

机构地区：[1]浙江省丽水市人民医院超声科,323000

出　　处：《中国全科医学》2017年第15期1894-1897,共4页Chinese General Practice

摘　　要：目的探讨经腹超声检测孕晚期子宫前壁下段厚度在预测瘢痕子宫再次分娩时术中发生破裂风险的价值。方法 2015年1月—2016年1月选择于丽水市人民医院分娩的瘢痕子宫孕妇150例,再次剖宫产前3 d内,应用经腹超声检测子宫前壁下段厚度。分析术中所见子宫前壁下段破裂情况(分为破裂组和未破裂组)与子宫前壁下段厚度之间的关系。绘制受试者工作特征(ROC)曲线评价子宫前壁下段厚度预测瘢痕子宫术中破裂风险的价值。结果破裂组53例,未破裂组97例。破裂组与非破裂组子宫前壁下段厚度分别为(1.21±0.34)、(2.17±0.53)mm,差异有统计学意义(t=12.009,P<0.05)。子宫前壁下段厚度预测瘢痕子宫术中破裂风险的截断值为1.55 mm,其灵敏度为0.903,特异度为0.210,ROC曲线下面积为0.913。结论当子宫前壁下段厚度<1.55 mm时提示瘢痕子宫术中发生破裂的风险较高。Objective To evaluate the application value of ultrasonic testing of lower uterine segment（LUS） thickness during late pregnancy in predicting uterine rupture in scarred uterus surgery among women with a previous cesarean section（CS）.Methods A total of 150 women with previous cesarean section choosing to deliver in Lishui People′s Hospital from January 2015 to January 2016 were selected.The ultrasonic testing was used to test LUS thickness within 3 days before re-caesarean section.The relationship between the status of rupture（women were divided into uterine rupture group and non-uterine rupture group） and thickness of the LUS identified in the surgery was analyzed.The receiver operating characteristic（ROC） curve was used to evaluate the predicative value of uterine rupture during surgery according to LUS thickness.Results There were 53 cases in uterine rupture group and 97 cases in non-uterine rupture group.LUS thickness was significantly different between uterine rupture group and non-uterine rupture group 〔（1.21＆#177;0.34）mm and（2.17＆#177;0.53）mm respectively,t=12.009,P〈0.00〕.The cut-off value of predicting uterine rupture during surgery according to LUS thickness was 1.55 mm,its predictive sensitivity and specificity was 0.903 and 0.210 respectively,the area under the ROC curve was 0.913.Conclusion The LUS thickness 〈1.55 mm indicates a high risk of uterine dehiscence.

关 键 词：瘢痕子宫 剖宫产术 再 超声检查 妊娠 子宫下段厚度 子宫破裂 

分 类 号：R711.4[医药卫生—妇产科学]