超声评估子宫动脉栓塞后清宫治疗瘢痕妊娠预后的价值  

Prognostic value of color Doppler ultrasound in cesarean scar pregnancy treated with curettage after uterine artery embolization

作　　者：杨志军 岳华 安晓娜 YANG Zhi-jun;YUE Hua;AN Xiao-na(Department of Ultrasound,Xidian Group Hospital,Xi'an 710077,Shaanxi,CHINA;Department of Obstetrics,Xidian Group Hospital,Xi'an 710077,Shaanxi,CHINA;Department of Obstetrics,Weinan Central Hospital,Weinan 714000,Shaanxi,CHINA)

机构地区：[1]西电集团医院超声科,陕西西安710077 [2]西电集团医院产科,陕西西安710077 [3]渭南市中心医院产科,陕西渭南714000

出　　处：《海南医学》2022年第5期610-612,共3页Hainan Medical Journal

基　　金：陕西省重点研发计划项目(编号:2021SF-347)。

摘　　要：目的 探讨彩色多普勒超声评估子宫动脉栓塞后清宫治疗瘢痕妊娠预后的价值。方法 回顾性分析西电集团医院2018年3月至2020年5月收治的115例行子宫动脉栓塞联合清宫术治疗的瘢痕妊娠患者的临床资料,所有患者均进行瘢痕妊娠超声分型,采用超声量化评分系统进行评分,统计患者术中、术后并发症情况,随访收集预后资料。结果 按照超声分型进行分组,其中Ⅰ型8例,Ⅱ型75例,Ⅲ型32例;按照超声评分进行分组,115例患者得分3~8分,其中3~6分者52例,>6分者63例;Ⅰ型患者术后2周及1个月时人绒毛膜促性腺激素(β-h CG)转阴率分别为87.50%、100.00%,明显高于Ⅱ型的40.00%、57.33%和Ⅲ型的31.25%、68.75%,差异均有统计学意义(P<0.05),而Ⅱ型及Ⅲ型的β-h CG转阴率比较差异无统计学意义(P>0.05);低分组患者术后2周及1个月时β-hCG转阴率分别为67.31%、76.92%,明显高于高分组的19.05%、57.14%,差异均有统计学意义(P<0.05);低分组患者术后2周腹部包块形成率为7.69%,明显低于高分组的19.05%,差异有统计学意义(P<0.05)。结论 超声分型及超声量化评分对子宫动脉栓塞联合清宫术后瘢痕妊娠预后有一定评估价值,可供临床治疗参考。Objective To investigate the prognostic value of color Doppler ultrasound in cesarean scar pregnancy treated with curettage after uterine artery embolization.Methods The clinical data of 115 patients with cesarean scar pregnancy who underwent uterine artery embolization combined with cesarean in Xidian Group Hospital from March 2018 to May 2020 were retrospectively analyzed.All patients were subjected to ultrasound classification of cesarean scar pregnancy,and an ultrasound quantitative scoring system was used for scoring.The intraoperative and postoperative complications were counted,and follow-up prognostic data were collected.Results According to ultrasound classification,there were 8 cases of type Ⅰ,75 cases of type Ⅱ,and 32 cases of type Ⅲ.According to the ultrasound score,the 115 patients scored 3-8,including 52 cases with score 3-6,and 63 cases with score>6.Two weeks and 1 month after operation,the negative conversion rates of hormone chorionic gonadotropin(β-hCG)in type Ⅰ group were 87.50%,100.00%,which were significantly higher than 40.00%,57.33% in type Ⅱ group and 31.25%,68.75%in type Ⅲ group(P<0.05).There was no significant difference in the negative conversion rate ofβ-hCG between type Ⅱ and type Ⅲ(P>0.05).The negative conversion rates of β-hCG in the low score group were 67.31%,76.92%,which were significantly higher than 19.05%,57.14%in the high score group(P<0.05).The abdominal mass formation rate in the low score group at 2 weeks after operation was 7.69%,which was significantly lower than 19.05% in the high score group(P<0.05).Conclusion Both ultrasound classification and ultrasound quantitative score are helpful for prognosis evaluation of cesarean scar pregnancy after uterine artery embolization conmbined with curettage,which provides reference for clinical treatment.

关 键 词：彩色多普勒超声 瘢痕妊娠 子宫动脉栓塞 清宫术 预后 超声量化评分系统 

分 类 号：R714.2[医药卫生—妇产科学]