经阴道彩色多普勒超声在切口妊娠术前诊断及术后监测中的应用  

Application of Transvaginal Color Doppler Ultrasound in Preoperative Diagnosis and Postoperative Monitoring of Incisional Pregnancy

作　　者：李娇娇 李静[1] 刘瑞明[1] LI Jiaojiao;LI Jing;LIU Ruiming(Department of Ultrasound,Lianyungang Maternal and Child Health Care Hospital,Lianyungang,Jiangsu 222000,China)

机构地区：[1]连云港市妇幼保健院超声科,江苏连云港222000

出　　处：《中国医药指南》2025年第9期103-106,共4页Guide of China Medicine

基　　金：连云港市卫生健康委员会2021年度科技项目[课题名称:经会阴盆底超声联合盆底肌力评估对产后盆底功能的监测及盆底康复治疗效果的研究(课题编号:ZD202104)]。

摘　　要：目的探讨经阴道彩色多普勒超声在切口妊娠术前诊断及术后监测中的应用价值。方法选取2022年1月至2024年8月期间连云港市妇幼保健院收治的132例疑似切口妊娠患者,所有患者均行经阴道彩色多普勒超声检查,并以手术及病理结果为金标准,分析其术前诊断准确性,同时对术后患者进行定期超声监测,观察子宫恢复情况及并发症发生情况。结果132例疑似切口妊娠患者中,经金标准确诊100例,经阴道彩色多普勒超声确诊98例;经阴道彩色多普勒超声诊断切口妊娠的特异性、灵敏度、准确率、阴性及阳性预测值、Kappa值分别为98.00%(98/100)、96.88%(31/32)、97.73%(129/132)、93.94%(31/33)、98.99%(98/99)、0.939,与金标准具有较高一致性;100例切口妊娠患者中,经金标准诊断为混合型、单纯妊囊型及嵌入型分别为49例、32例、19例,经阴道彩色多普勒超声诊断为混合型、单纯妊囊型及嵌入型分别为48例、32例、18例,经阴道彩色多普勒超声诊断为混合型、单纯妊囊型及嵌入型诊断的符合率分别为97.96%(48/49)、100.00%(32/32)、94.74%(18/19);术后超声监测发现,所有患者治疗后的效果高于治疗前(P<0.05);术后患者有2例少量宫腔积液,发生率为2.00%(2/100)。结论经阴道彩色多普勒超声在切口妊娠术前诊断中具有较高的准确性,能够为临床治疗提供重要依据,且在术后监测中可有效观察子宫恢复情况,及时发现并处理并发症。Objective To investigate the application value of transvaginal color Doppler ultrasound in the preoperative diagnosis and postoperative monitoring of incisional pregnancy.Methods From January 2022 to August 2024,admitted 132 cases of suspected incision pregnancy in Lianyungang Maternal and Child Health Care Hospital,all patients are transvaginal color Doppler ultrasound examination,and surgery and pathological results as the gold standard,analyze the preoperative diagnosis accuracy,at the same time for postoperative patients with regular ultrasound monitoring,observe the uterine recovery and complications.Results The 132 patients with suspected incision pregnancy,100 cases were confirmed by the gold standard,98 cases were confirmed by transvaginal color Doppler ultrasound.The specificity,sensitivity,accuracy,negative and positive predictive value,Kappa value were 98.00%(98/100),96.88%(31/32),97.73%(129/132),93.94%(31/33),98.99%(98/99),0.939,respectively,have a high consistency with the gold standard.The 100 patients with incisional pregnancy,by the gold standard,the pure pregnant sac model and the embedded type were diagnosed in 49,32 and 19 cases,respectively,transvaginal color Doppler ultrasound diagnosis was mixed type,pure pregnancy type and embedded type in 48 cases,32 cases,and 18 cases,the coincidence rate of transvaginal color Doppler ultrasound diagnosis in mixed type,pure pregnancy sac model and embedded model diagnosis was 97.96%(48/49),100.00%(32/32),94.74%(18/19),respectively.Postoperative ultrasound monitoring revealed that,All patients had higher effects after treatment than those before treatment(P<0.05).Two postoperative patients had a small amount of intrauterine effusion,the incidence rate was 2.00%(2/100).Conclusions Transvaginal color Doppler ultrasound has high accuracy in preoperative diagnosis of incision pregnancy,can provide important basis for clinical treatment,and can effectively observe uterine recovery in postoperative monitoring,and detect and handle complications in time.

关 键 词：经阴道彩色多普勒超声 切口妊娠 术前诊断 术后监测 前壁下段肌层厚度 

分 类 号：R714.2[医药卫生—妇产科学]