超声征象评分法诊断凶险性前置胎盘合并胎盘植入的应用  

The Value of Prenatal Diagnosis of Ultrasonographic Scoring System in Placenta Previa with Placenta Accrete

作　　者：朱艳玲[1] 牛兆仪[1] 靳晴[1] 李丽荣[1] 马雄涛 马永红[2] ZHU Yan-ling1,NIU Zhao-yi1,JIN Qin1,LI Li-rong1,MA Xiong-tao1,MA Yong-hong2(1.Dept. of Obstetrics,The Affiliated Yan＇an Hospital of Kunming Medical University;2.Dept. of Ultrasound,The First Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650031,China)

机构地区：[1]昆明医科大学附属延安医院产科,云南昆明650051 [2]昆明医科大学第一附属医院妇产科超声,云南昆明650031

出　　处：《昆明医科大学学报》2018年第4期113-116,共4页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(8156040189)

摘　　要：目的总结凶险性前置胎盘(PPP)合并胎盘植入时的超声特征,探讨超声征象评分法用于评估PPP是否合并胎盘植入的临床价值.方法对昆明医科大学附属延安医院行剖宫产分娩的179例PPP病例的超声特征进行回顾性分析,以产后结果为金标准,分为非植入型和植入型.结果非植入型PPP与植入型PPP的超声评分有统计学差异(P<0.05);将胎盘厚度、胎盘后间隙、胎盘实质旋涡情况、胎盘基底部-子宫交界面血流、子宫浆膜层-膀胱交界面情况、宫颈形态6个指标纳入ROC曲线分析,非植入型和植入型的超声评分最佳分界点为6分.结论超声征象评分法用来评估凶险性前置胎盘是否合并胎盘植入具有较高特异性和敏感度,是可靠的辅助检查方法,具有良好的应用前景.Objective To summarize the characteristics of PPP disease complex with placenta implication and explore the value of prenatal ultrasonographic scoring system in placenta prevlia complicate with placenta accrete.Me thods An retrospective analysis was conducted among 179 case of ultrasound images of pernicious placenta previa complicate with placenta accrete, and the results of postpartum were compared. Based on clinical surgery and/or pathological results as the gold standard, all cases were divided into adhesive placenta accreta group and non-adhesive placenta accreta group. Re s ults Logistic regression identified six sonographic parameters,including placenta thickness, obliteration of retroplacental hypoechoic space, smallest sagittal myometrial thickness,presence of abnormal vessels linking the placenta to the bladder, lacunar flow distributed within intraparenchymal placenta area and the cervical form. Different scores were assigned according to the odds ratio of these parameters.The critical score of the ultrasound score of adhesive placenta accreta and non-adhesive placenta was 6 points.Conclus ions Prenatal ultrasonographic scoring system is a reliable method to diagnose the degree of the accretion in pernicious placenta previa complicate with placenta accrete.

关 键 词：产前超声 胎盘植入 凶险性前置胎盘 诊断评分 

分 类 号：R445.1[医药卫生—影像医学与核医学]