经阴道彩色多普勒超声在子宫切口妊娠中的诊断及治疗价值  

Diagnostic and therapeutic value of transvaginal color Doppler sonography on diagnosis of cesarean scar pregnancy

作　　者：王静 WANG Jing(Color Ultrasonic Room,Liaoyang Maternity Hospital,Liaoyang 111000,China)

机构地区：[1]辽阳妇产医院彩超室,111000

出　　处：《中国实用医药》2022年第17期70-72,共3页China Practical Medicine

摘　　要：目的 分析经阴道彩色多普勒超声(彩超)诊断和治疗子宫切口妊娠(CSP)的效果。方法 选取42例经手术和病理确诊为CSP的患者作为观察组,另选取45例正常妊娠孕妇作为对照组。两组均行经阴道彩超检查治疗,比较两组超声检查指标(孕囊和切口距离、子宫动脉的血流阻滞指数、切口肌层厚度及切口假腔情况),并分析观察组CSP检出率、治疗成功率、并发症发生情况及不同类型CSP患者的超声影像表现。结果 观察组经阴道彩超CSP检出40例,检出率为95.24%(40/42),其中孕囊型、混合团块型检出率依次为95.45%(21/22)、95.00%(19/20)。观察组的孕囊和切口距离(0.28±0.06)cm、子宫动脉的血流阻滞指数(0.35±0.08)、切口肌层厚度(4.02±1.08)cm均小于对照组的(3.12±1.02)cm、(0.80±0.14)、(7.75±1.65)cm,切口假腔占比19.05%高于对照组的0,差异具有统计学意义(P<0.05)。超声检查显示为孕囊型的21例患者中,子宫前壁的下段切口位置能观察到孕囊回声,部分孕囊中存在胚芽和原始心管搏动;超声检查显示混合团块型的19例患者中,子宫下段与宫腔中能观察到团状分布的杂乱混合回声。42例CSP患者均于超声引导下开展一次性的手动负压吸引器宫腔镜手术,同时手术结束后均进行3个月以上随访,最终治疗均获取成功,治疗成功率为100.00%,未出现严重并发症,所有患者对治疗工作均表示满意。结论 经阴道彩超在诊断和治疗CSP中有着较高价值,对临床评估患者的病情及疗效、选取后续治疗方案有着重要指导作用。Objective To analyze the effect of transvaginal color Doppler sonography on diagnosis of cesarean scar pregnancy(CSP).Methods 42 cases of CSP patients diagnosed by surgery and pathology were selected as the observation group,and 45 normal pregnant women were selected as the control group.Transvaginal color Doppler sonography was performed in both groups to compare the distance between the gestational sac and the incision,the blood flow restriction index,muscular layer thickness and false lumen,and to analyze the detection rate of CSP,the treatment success rate,the occurrence of complications,and ultrasound imaging findings of patients with different types of CSP in the observation group.Results In the observation group,the CSP detection rate based on transvaginal color Doppler sonography was 95.24%,among which the detection rates of gestational sac type and mixed mass type were 95.45%(21/22)and 95.00%(19/20).In the observation group,the distance between the gestational sac and the incision was(0.28±0.06)cm,the blood flow restriction index was(0.35±0.08),and the muscular layer thickness was(4.02±1.08)cm,which were less than(3.12±1.02)cm,(0.80±0.14),(7.75±1.65)cm in the control group;the false lumen rate 19.05%was higher than 0 of the control group;all the difference was statistically significant(P<0.05).In 21 patients of the gestational sac type,gestational sac echos could be observed in the lower segment of the anterior uterine wall at the location of the incision,with the presence of germinal buds and primitive heart tube pulsations in some of the gestational sacs;in 19 patients of mixed mass type,a disorganized mixed echogenicity with a mass distribution could be observed in the lower segment of the uterus and the uterine cavity.Under the guidance of ultrasound,42 CSP patients completed the one-time surgery with manual vacuum extractor and were followed for 3 months or above.The treatment rate was 100.00%;no serious complications occurred;all of patients were satisfactory.Conclusion Transvaginal color Dop

关 键 词：子宫切口妊娠 经阴道彩色多普勒超声 检出率 治疗方式 

分 类 号：R445.1[医药卫生—影像医学与核医学] R719.8[医药卫生—诊断学]