彩超在剖宫产术后子宫瘢痕妊娠诊治中的应用  

Color Doppler Flow Imaging in Diagnosis and Treatment of Cesarean Scar Pregnancy

作　　者：姜川 郑远琴 姜莲 牟奇彬 张春蓉 JIANG Chuan;ZHENG Yuanqin;JIANG Lian;MOU Qibin;ZHANG Chunrong(Ultrasound Department,Chongqing Wanzhou Maternal and Child Health Hospital,Chongqing 404000,China)

机构地区：[1]重庆市万州区妇幼保健院超声科,重庆404000

出　　处：《中国继续医学教育》2019年第4期77-79,共3页China Continuing Medical Education

基　　金：重庆市万州区科技计划项目(20130321)

摘　　要：目的本文探讨彩色多谱勒血流显像在剖宫产术后子宫瘢痕妊娠(CSP)诊治中的应用价值。方法选取2017年2—12月的73例CSP患者为观察组,2016年8月—2017年1月的54例CSP患者为对照组,对所有患者术前超声情况,以及术中术后情况进行回顾性对比分析。结果对照组54例CSP患者中Ⅰ型15例,Ⅱ型27例,Ⅲ型12例;其中Ⅰ型15例和Ⅱ型5例选择方案1治疗,发生3例大出血转开腹手术;其中Ⅱ型22例和Ⅲ型12例选择方案2治疗,发生7例大出血。观察组73例CSP患者中Ⅰ型26例,Ⅱ型32例,Ⅲ型15例。同时按Adler方法进行彩色多谱勒血流信号分级判定,其中24例为少血流组选择方案1治疗,手术顺利,无大出血发生;49例为富血流组,选择方案2治疗,手术顺利,有4例大出血发生。结论彩色多谱勒血流显像对CSP患者选择治疗方案具有较好的指导意义,按分组(富血流组和少血流组)分型进行治疗的CSP患者术中大出血发生率明显小于未分组进行治疗的CSP患者。Objective To discuss the value of color Doppler flow imaging in the diagnosis and treatment of cesarean scar pregnancy(CSP).Methods 73 CSP patients from February to December 2017 were selected as the observation group,and 54 CSP patients from August 2016 to January 2017 were selected as the control group.We conducted a retrospective comparative analysis of preoperative ultrasound and intraoperative and postoperative conditions of all patients.Results TypeⅠ15 cases in the control group of 54 patients with CSP,27 casesⅡtype,typeⅢ12 cases;Ⅰtype 15 cases andⅡtype 5 cases treatment options 1,3 cases of hemorrhage rupture open operation;Including 22 casesⅡtype and 12 casesⅢtype 2 treatment options,7 cases of hemorrhage.In the observation group,73 cases of patients with CSPⅠ26 cases,Ⅱtype 32 cases,15 casesⅢtype.At the same time,color doppler flow signal classification was performed according to Adler method,in which 24 cases were selected as the group with low blood flow,and the treatment was carried out successfully without major bleeding.Forty-nine patients were in the group with rich blood flow.Option 2 was selected for treatment,and the operation was successful,with 4 cases of massive hemorrhage.Conclusion The incidence of intraoperative hemorrhage in CSP patients treated by grouping(rich blood flow group and little blood flow)was significantly lower than that in CSP patients not treated by grouping.Color Doppler flow imaging is of great guiding significance for CSP patients to choose treatment plan.

关 键 词：剖宫产术后子宫瘢痕妊娠 超声分型 彩色多谱勒血流显像 富血流组 少血流组 治疗方案 

分 类 号：R714[医药卫生—妇产科学]