探讨彩色多普勒超声产前诊断前置胎盘并发胎盘植入的价值  

Study on Value of Color Doppler Ultrasound in the Prenatal Diagnosis of Placenta Previa Combined with Placenta Implantation

作　　者：王勤[1] WANG Qin(Department of Ultrasound,Shuyang Hospital of TCM,Shuyang,Jiangsu Province,223600 China)

机构地区：[1]沭阳县中医院超声科,江苏沭阳223600

出　　处：《系统医学》2017年第24期85-86,89,共3页Systems Medicine

摘　　要：目的探讨彩色多普勒超声产前诊断前置胎盘并发胎盘植入的价值。方法选取该院产科病房住院待产(2015年2月—2017年2月)40例前置胎盘孕妇为研究对象,均进行阴道和腹部超声检查,然后对比其与病理检查结果的差异。结果该研究40例前置胎盘孕妇经彩色多普勒超声诊断,确认合并胎盘植入8例,而经剖宫产手术病理证实,合并胎盘植入9例,术前超声明确诊断7例,彩色多普勒超声诊断确诊率为77.78%(7/9),有1例孕妇胎盘早剥被误诊,漏诊2例;声像表现:胎盘厚度加大,其内部能见范围不等的液性暗区和胎盘漩涡,不能探及大多胎盘后间隙,可能完全消失,多不能显示胎盘和子宫壁肌层间的蜕膜界面,子宫壁肌层变薄或消失;血流显像表现:胎盘漩涡中部多无回声区,而靠近子宫肌层的区域能见血流信号,且很丰富,子宫旁血管变粗,血流紊乱。结论彩色多普勒超声检查灵敏度很高,可清晰显示胎盘后间隙和胎盘内血流情况,能准确诊断产前前置胎盘并发胎盘植入,临床应用价值高。Objective To study the value of color Doppler ultrasound in the prenatal diagnosis of placenta previa combined with placenta implantation.Methods 40 cases of delivery women with placenta previa waiting for delivery in our hospital from February 2015 to February 2017 were selected for vagina and abdominal ultrasound,and the differences compared with the pathological examination results was compared.Results The color Doppler ultrasound diagnosis of 40 cases in this research showed that 8 cases were confirmed with placenta implantation,but the cesarean section operation pathology proves that there were 9 cases with placenta implantation,and 7 cases were definitely diagnosed by the ultrasound before surgery,and the confirmation rate of color Doppler ultrasound was 77.78%(7/9),and 1 case of pregnant women were misdiagnosed with placental abruption,2 cases were missed diagnosis,and the sonographic manifestations:the thickness of placenta increased,different ranges of opaque dark area of fluid andplacenta swirl could be seen inside,the gas after placenta failed to be explored,which may totally disappear,most failed to show the deciduas interface of placenta and myometrium,the myometrium thinned or disappeared,and the display of blood flow manifestations:echo-free spaces were most in placenta swirl,and the blood flow signal can be seen near the myometrium region,and it was rich,and the blood vessels near uteruses was thickened and the blood flow was disorder.Conclusion The sensitivity of color doppler ultrasound is very high,which can clearly show the gas after placenta and blood flow in placenta,and it can accurately diagnose the Placenta previa combined with placenta implantation,and the clinical application value is high.

关 键 词：彩色多普勒超声 前置胎盘 胎盘植入 

分 类 号：R722.12[医药卫生—儿科]