经阴道超声诊断剖宫产术后瘢痕妊娠的应用  

Application of Transvaginal Ultrasound in the Diagnosis of Scar Pregnancy After Cesarean Section

作　　者：徐影[1] 李威[2] 宋文龄[3] XU Ying;LI Wei;SONG Wenling(Department of Obstetrics and Gynecology,Changchun Central Hospital,Changchun Jilin 130051,China;Department of Electrodiagnosis,Siping Maternal and Infant’s Hospital,Jilin Province,Siping Jilin 136000,China;Prenatal Diagnosis Center,The Second Hospital of Jilin University,Changchun Jilin 130000,China)

机构地区：[1]长春市中心医院妇产科,吉林长春130051 [2]吉林省四平市妇婴医院电诊科,吉林四平136000 [3]吉林大学第二医院产前诊断中心,吉林长春130000

出　　处：《中国继续医学教育》2020年第31期124-128,共5页China Continuing Medical Education

基　　金：吉林省卫生健康适宜技术推广项目(2019S022)。

摘　　要：目的探讨经阴道超声诊断剖宫产术后瘢痕妊娠的应用价值。方法80例疑似子宫瘢痕妊娠女性均行经腹超声检查和经阴道超声检查。以手术病理结果为金标准,分析两种超声检查方式单用及联用对子宫瘢痕妊娠的诊断效能。结果腹部超声诊断阳性50例,阴性30例;经阴道超声诊断阳性62例,阴性18例;两项联合超声诊断阳性65例,阴性15例。经阴道超声对子宫瘢痕妊娠的诊断敏感度、准确度及阴性预测值均明显高于腹部超声(P<0.05)。两项联合超声对子宫瘢痕妊娠的准确度显著高于腹部超声及经阴道超声(P<0.05)。结论腹部超声和经阴道超声在剖宫产术后瘢痕妊娠诊断中各有优缺点,二者联用可有效提高瘢痕子宫妊娠的诊断效能。Objective To explore the value of transvaginal ultrasound diagnosis of scar pregnancy after cesarean section.Methods Eighty pregnant women with suspected uterine scars underwent transabdominal ultrasound and transvaginal ultrasound.Taking the pathological results of surgery as the gold standard,the diagnostic efficacy of two ultrasound methods alone and in combination for uterine scar pregnancy was analyzed.Results Abdominal ultrasound diagnosis was positive in 50 cases and negative in 30 cases;transvaginal ultrasound diagnosis was positive in 62 cases and negative in 18 cases;two combined ultrasound diagnosis was positive in 65 cases and negative in 15 cases.The diagnostic sensitivity,accuracy and negative predictive value of transvaginal ultrasound for uterine scar pregnancy are significantly higher than that of abdominal ultrasound(P<0.05).The accuracy of the two combined ultrasounds for the diagnosis of uterine scar pregnancy were significantly higher than those of abdominal ultrasound and transvaginal ultrasound(P<0.05).Conclusion Abdominal ultrasound and transvaginal ultrasound have their own advantages and disadvantages in the diagnosis of scar pregnancy after cesarean section.The combination of the two can effectively improve the diagnostic efficiency of scar pregnancy.

关 键 词：瘢痕妊娠 剖宫产 经阴道 腹部超声 诊断 病理 敏感度 

分 类 号：R714[医药卫生—妇产科学]