超声评分预测有胎盘植入风险孕妇剖宫产术中出血量的应用价值  

Value of Ultrasound Score in Predicting Blood Loss During Caesarean Section in Pregnant Women at Risk of Placenta Accreta Spectrum

作　　者：张书杰[1] 姜凡[1] 罗平[1] 顾莉莉[1] 张贤月 Zhang Shujie;Jiang Fan;Luo Ping;Gu Lili;Zhang Xianyue(Department of Ultrasound,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声医学科,合肥市230601

出　　处：《中国超声医学杂志》2023年第7期797-800,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声评分对有胎盘植入(PAS)风险孕妇剖宫产术中出血量的预测价值。方法回顾性分析52例有PAS风险孕妇的超声评分结果及剖宫产术中止血方式、术中出血量、术中所见胎盘植入程度及术后病理、妊娠结局、输血制品情况。结果超声评分和剖宫产术中出血量呈正相关(r=0.74,P<0.01),两者线性回归方程为:术中出血量=264.96×超声评分-257.47,R^(2)=0.5938。超声评分>6.5分对剖宫产术中大出血(≥1000 mL)有预测作用,灵敏度为66.7%,特异度为90.3%;超声评分>3.5分对患者围术期是否需要输血有预测作用,灵敏度为92.9%,特异度为70.8%。结论超声评分对PAS风险孕妇剖宫产术中出血量有较好的预测作用。Objective To evaluate the value of ultrasound score in predicting blood loss during caesarean section in pregnant women at risk of placenta accreta spectrum(PAS).Methods A retrospective analysis was performed on the results of ultrasound score,hemostasis during caesarean section,intraoperative blood loss,degree of placenta accretion,postoperative pathology,pregnancy outcome and transfusion of blood products in 52 pregnant women at risk of PAS.Results There was a positive correlation between ultrasound score and the amount of blood loss during cesarean section(r=0.74,P<0.01).The linear regression equation of the two was as follows:intraoperative blood loss=264.96×ultrasound score-257.47,R^(2)=0.5938.The ultrasound score6.5 had a predictive value of massive bleeding(≥1000 mL)during caesarean section,with a sensitivity of 66.7%and specificity of 90.3%.The ultrasound score>3.5 had a predictive effect on the need for blood transfusion in the perioperative period with a sensitivity of 92.9%and specificity of 70.8%.Conclusions Ultrasound score can help to predict the amount of blood loss during caesarean section in pregnant women at risk of PAS.

关 键 词：超声评分 胎盘植入性疾病 剖宫产术 出血量 

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]