经腹超声及经阴道超声在剖宫产术后CSP中的诊断价值  

Value of Transabdominal Ultrasound and Transvaginal Ultrasound in Diagnosis of Postoperative Cesarean Scar Pregnancy

作　　者：郑卫[1] 王佳旭[1] ZHENG Wei;WANG Jiaxu(Department of Function,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China)

机构地区：[1]河北北方学院附属第二医院功能科,河北张家口075100

出　　处：《医学综述》2020年第11期2284-2288,共5页Medical Recapitulate

摘　　要：目的探讨经腹超声及经阴道超声在剖宫产术后子宫瘢痕妊娠(CSP)中的诊断价值。方法选择2016年1月至2018年12月河北北方学院附属第二医院诊治的80例疑似剖宫产CSP患者,行彩色多普勒超声检查,比较经腹超声、经阴道超声、经腹联合经阴道超声检查对剖宫产术后CSP的诊断价值。结果经腹联合经阴道超声检查的灵敏度、特异度、准确度分别为93.8%(62/64)、96.9%(15/16)、96.3%(77/80),高于经腹超声检查[85.9%(55/64)、75.0%(12/16)、83.8%(67/80)]和经阴道超声检查[89.1%(57/64)、81.3%(13/16)、87.5%(70/80)]。经腹联合经阴道超声检查对剖宫产CSP型检出率为92.2%(59/64),与病理学检查结果(100.0%)比较差异无统计学意义(P>0.05)。孕囊型、不匀质包块型、混合型CSP阴道超声影像图像的特征明显。CSP患者治疗后子宫前壁下段肌层厚度和阻力指数均大于治疗前[(7.19±1.65)mm比(3.86±1.11)mm,0.77±0.12比0.45±0.11](P<0.01)。结论经腹联合经阴道超声检查可作为剖宫产术后CSP的首选诊断方法,影像学图像特征明显,诊断准确性、特异性、敏感性较高,可指导临床治疗。Objective To explore the value of transabdominal ultrasound and transvaginal ultrasound in the diagnosis of postoperative cesarean scar pregnancy(CSP).Methods The clinical data of 80 patients with suspected CSP diagnosed and treated in the Second Affiliated Hospital of Hebei North University from Jan.2016 to Dec.2018 were analyzed retrospectively.Color Doppler ultrasound was performed to compare the diagnostic value of transabdominal ultrasound,transvaginal ultrasound and transabdominal combined transvaginal ultrasound for CSP.Results The sensitivity,specificity and accuracy of transabdominal combined transvaginal ultrasound examination were 93.8%(62/64),96.9%(15/16),96.3%(77/80),higher than those of transabdominal ultrasound examination[85.9%(55/64),75.0%(12/16),83.8%(67/80)]and transvaginal ultrasound examination[89.1%(57/64),81.3%(13/16),87.5%(70/80)].The detection rate of CSP by combined abdominal and transvaginal ultrasound examination was 92.2%(59/64),which was not statistically different from the results of pathological examination(100.0%)(P>0.05).The imaging features of pregnancy sac,heterogeneous mass and mixed CSP in vaginal ultrasound were obvious.After treatment,the thickness and resistance index of the inferior segment of the anterior wall of the uterus in the CSP patients were higher than those before treatment[(7.19±1.65)mm vs(3.86±1.11)mm,0.77±0.12 vs 0.45±0.11](P<0.01).Conclusion Transabdominal combined with transvaginal ultrasound can be used as the first choice for diagnosis of CSP,which is featured with obvious imaging features,higher diagnostic accuracy,specificity and sensitivity,and can be used to guide the clinical treatment.

关 键 词：剖宫产 术后子宫瘢痕妊娠 彩色多普勒超声 

分 类 号：R714.22[医药卫生—妇产科学]