瘢痕子宫下段肌层厚度行经腹结合经阴道超声监测的临床价值  

Diagnostic value of transabdominal combined with transvaginal ultrasound in detecting the thickness of muscular layer in the lower segment of scarred uterus

作　　者：迟玉君 张中华 宁英 李春玲 董艳蕊 许新 CHI Yujun;ZHANG Zhonghua;NING Ying;LI Chunling;DONG Yanrui;XU Xin(Department of Ultrasound,Cangzhou Maternal and Child Health Hospital,Cangzhou 061000,China;Pbstetrics Reprotment,Cangzhou Maternal and Child Health Care Hospital,Cangzhou 061000,China;Matermal Health Depvrtment,Cangzhou Maternal and child Health Care Hospital Obstetrics,Cangzhou 061000,China)

机构地区：[1]河北省沧州市妇幼保健院超声科,河北沧州061000 [2]河北省沧州市妇幼保健院妇保科,河北沧州061000 [3]河北省沧州市妇幼保健院产科,河北沧州061000

出　　处：《医学影像学杂志》2022年第9期1548-1550,共3页Journal of Medical Imaging

基　　金：河北省沧州市科技计划项目(编号:162302089)。

摘　　要：目的探讨瘢痕子宫前壁下段肌层厚度行经腹结合经阴道超声监测的临床价值。方法选取156例既往剖宫产再次分娩孕妇,根据超声监测的子宫前壁下段肌层厚度将病例分为A,B两组:A组为经腹结合经阴道超声监测80例,B组为经腹超声监测76例,采用彩超测量孕妇妊娠32周至孕40周的子宫前壁下段肌层厚度。经腹监测前孕妇适度憋尿充盈膀胱,测量子宫下段肌层厚度前检查膀胱充盈度。膀胱过度充盈者嘱其排出部分尿液后再测量子宫前壁下段肌层厚度,膀胱充盈不足者再憋尿测量。孕妇分别由3位高年资超声医师测量子宫前壁下段肌层厚度。结果A组监测孕32周、孕35周、孕38周的子宫下段肌层厚度显著低于B组,差异有统计学意义(P<0.05);A组的子宫瘢痕显影率、子宫瘢痕愈合情况显著优于B组,差异有统计学意义(P<0.05)。子宫前壁下段肌层厚度≥2 mm的自然分娩率显著高于<2 mm者,而剖宫产率显著低于<2 mm者,差异有统计学意义(P<0.05)。结论瘢痕子宫前壁下段肌层厚度进行经腹结合经阴道超声监测可提高子宫瘢痕的显影率及检查的准确性。Objective To explore the diagnostic value of abdominal combined with transvaginal ultrasound monitoring of the thickness of the lower segment of the anterior wall of the scarred uterus and its influence on the mode of delivery.Methods 156 pregnant women who gave birth again after previous cesarean section were selected.According to the thickness of the lower segment of the anterior wall of the uterus monitored by ultrasound,the cases were divided into two groups:80 cases in group A were monitored by transabdominal combined with transvaginal ultrasound,and 76 cases in group B were monitored by transabdominal ultrasound.The thickness of the lower segment of the anterior wall of the uterus was measured by transvaginal probe of color Doppler ultrasound from 32 weeks to 40 weeks of pregnancy.Before monitoring,the patient moderately suppressed urine to fill the bladder,and the bladder filling degree was checked before measuring the thickness of the lower uterine myometrium.If the bladder was over filled,we asked him to excrete part of the urine before measuring the thickness of the lower segment of the anterior wall of the uterus.If the bladder was under filled,we measured the thickness of the lower segment of the anterior wall of the uterus again.For each pregnant woman,the thickness of the lower segment of the anterior wall of the uterus was measured by three senior ultrasound doctors,and the average value was recorded as the observation index.So we observed the relationship between the mode of delivery and the thickness of the lower segment of the anterior wall of the uterus.Results The thickness of the lower segment of the uterus in group A was significantly lower than that in group B at 32,35 and 38 weeks of gestation(P<0.05);The development rate of uterine scar and the healing of uterine scar in group A were significantly better than those in group B(P<0.05).The natural delivery rate of the observation group was significantly higher than that of the control group,while the cesarean section rate was significantly

关 键 词：瘢痕子宫 经阴道超声检查 腹部超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.2[医药卫生—诊断学]