经阴道超声加经腹浅表超声测定瘢痕子宫再次妊娠分娩前子宫前壁下段肌层厚度的临床价值  

The Clinical Value of Transvaginal Ultrasound Combined with Transabdominal Superficial Ultrasound in Measuring the Thickness of the Lower Segment of the Anterior Wall of the Uterus Before Delivery of a Scarred Uterus in a Second Pregnancy

作　　者：谢贤海 郑宗杰 XIE Xian-hai;ZHENG Zong-jie(Department of Ultrasonography,Qingliu County General Hospital,Sanming City,Fujian Province,Fujian Sanming 365300;Department of Ultrasound Medicine,the First Hospital of Sanming City,Fujian Province,Fujian Sanming 365000)

机构地区：[1]福建省三明市清流县总医院超声科,福建三明365300 [2]福建省三明市第一医院超声医学科,福建三明365000

出　　处：《中国医疗器械信息》2024年第15期124-126,共3页China Medical Device Information

摘　　要：目的:探讨与分析经阴道超声加经腹浅表超声测定瘢痕子宫再次妊娠分娩前子宫前壁下段肌层厚度的临床价值。方法:选择2021年2月~2023年8月在本院就诊的瘢痕子宫再次妊娠产妇80例作为研究对象,对所有患者进行经阴道超声加经腹浅表超声检查,记录子宫瘢痕超声分级与愈合不良情况,测量子宫前壁下段肌层厚度与判定诊断价值。结果:在80例产妇中,都给予剖宫产分娩,子宫瘢痕Ⅰ级瘢痕50例,Ⅱ级瘢痕20例、Ⅲ级瘢痕8例、Ⅳ级瘢痕2例,为金标准,愈合良好50例,愈合不良30例。愈合良好组的前次剖宫产间隔时间、孕次、产次、年龄、孕周等与愈合不良组对比无差异(P>0.05)。愈合良好组的子宫前壁下段肌层厚度与愈合不良组对比有显著提高(P<0.05)。经阴道超声加经腹浅表超声判断为愈合良好48例,经阴道超声加经腹浅表超声测定瘢痕子宫再次妊娠分娩前子宫前壁下段肌层厚度判断子宫瘢痕愈合良好的敏感性、特异性、准确性分别为92.00%、93.33%、92.50%。结论:经阴道超声加经腹浅表超声可通过测定瘢痕子宫再次妊娠分娩前子宫前壁下段肌层厚度,为临床提供子宫下段信息,可有效预测愈合不良发生情况。Objective:To explore and analysis the clinical values of transvaginal ultrasound combined with transabdominal superficial ultrasound in measuring the thickness of the lower segment of the anterior wall of the uterus before delivery of a scarred uterus.Methods:From February 2021 to August 2023,80 cases of pregnant women with scarred uterus who underwent re pregnancy treatment at a our hospital were selected as the research subjects.All patients were underwent transvaginal ultrasound and superficial abdominal ultrasound examination,recording the ultrasound grading and poor healing of uterine scars,detected the thickness of the lower segment of the anterior uterine wall muscle layer,and determined the diagnostic values.Results:Among the 80 women,they were delivered by cesarean section,50 with grade I scar,20 with grade scar,8 with grade scar and 2 with grade scar,which was the gold standard,50 with good healing and 30 with poor healing.There was no difference between the interval,pregnancy,delivery,age and gestational age of the good healing group and the poor healing group(P>0.05).The myometrial thickness of the inferior anterior wall segment was significantly improved compared with the poor healing group(P<0.05).Transvaginal ultrasound and superficial abdominal ultrasound,specificity and accuracy of good scar healing in the previous wall were 92.00%,93.33%and 92.50%.Conclusion:Transvaginal ultrasound and transsuperficial abdominal ultrasound can determine the thickness of the inferior muscle layer of the anterior wall of the uterus,provide clinical information on the lower uterine segment and effectively predict the occurrence of poor healing.

关 键 词：经阴道超声 经腹浅表超声 瘢痕子宫 子宫前壁下段肌层厚度 愈合不良 

分 类 号：R445.1[医药卫生—影像医学与核医学]