超声量化评分系统在剖宫产瘢痕妊娠临床治疗中的应用价值  

Application value of ultrasonic quantitative scoring system in clinical treatment of cesarean scar pregnancy

作　　者：满竹 韩阳 陈震宇 Man Zhu;Han Yang;Chen Zhenyu(Department of Obstetrics and Gynecology,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院妇产科,沈阳110016

出　　处：《中国临床实用医学》2025年第1期25-29,共5页China Clinical Practical Medicine

基　　金：辽宁省科学技术计划项目(2022JH2/101500029)。

摘　　要：目的探讨超声量化评分系统在剖宫产瘢痕妊娠(CSP)临床治疗中的应用价值。方法本研究为回顾性病例对照研究,选取2022年1月至2024年1月北部战区总医院妇产科收治的135例CSP患者,年龄(27.00±7.43)岁,年龄范围为24~37岁,采用超声量化评分系统预测治疗前CSP患者的临床特征及治疗方式,记录患者的治疗方式,并对超声量化评分系统预测CSP患者的治疗方式进行一致性检验。结果超声监视下负压吸宫术、超声监视下负压吸宫术+宫腔镜手术、超声监视下负压吸宫术+宫腔镜手术+缺陷修补术患者的剖宫产次数、妊娠囊血流分级、妊娠囊最长径、剩余子宫肌层厚度、胎心搏动、妊娠囊分型及术中出血量比较,差异有统计学意义(P<0.05)。预测超声监视下负压吸宫术治疗的85例患者中,80例患者符合预测,5例患者行超声监视下负压吸宫术+宫腔镜手术,预测准确率为94.1%(80/85);预测行超声监视下负压吸宫术+宫腔镜手术治疗的43例患者中,36例患者符合预测,4例患者行超声监视下负压吸宫术,3例患者行宫腔镜手术+缺陷修补术后恢复,准确率为83.7%(36/43);预测行超声监视下负压吸宫术+宫腔镜手术+缺陷修补术的7例患者中,5例患者符合预测,2例患者行经腹超声监视下负压吸宫术+宫腔镜手术,准确率为71.4%(5/7),一致性检验相关系数为0.739,Kappa值为0.811(r=0.739,P=0.001)。结论超声量化评分系统对CSP患者治疗方案预测的准确率较高。ObjectiveTo explore the application value of ultrasonic quantitative scoring system in the clinical treatment of cesarean scar pregnancy(CSP).MethodsThis study was a retrospective case-control study,a total of 135 patients with CSP admitted to department of Obstetrics and Gynecology in General Hospital of Northern Theater Command from January 2022 to January 2024 were selected,the patients were aged(27.00±7.43)years old,ranging from 24 to 37 years old.The ultrasonic quantitative scoring system was used to predict the clinical characteristics and treatment methods of CSP patients before treatment,the treatment methods of patients were recorded,and the consistency test was conducted for the treatment methods of CSP patients predicted by the ultrasonic quantitative scoring system.ResultsComparison of cesarean section times,gestational sac blood flow grade,longest diameter of gestational sac,remaining myometrium thickness,fetal heart beat,gestational sac type and intraoperative blood loss of patients undergoing negative pressure aspiration under ultrasonic monitoring,negative pressure aspiration under ultrasonic monitoring+hysteroscopic surgery,negative pressure aspiration under ultrasonic monitoring+hysteroscopic surgery+defect repair,and the differences were statistically significant(P<0.05).Among the 85 patients were predicted to undergo negative pressure aspiration under ultrasonic monitoring,including 80 patients were in line with the prediction,and 5 patients were treated with negative pressure aspiration under ultrasonic monitoring+hysteroscopic surgery,the prediction accuracy was 94.1%(80/85).Among the 43 patients were predicted to undergo negative pressure aspiration under ultrasonic monitoring+hysteroscopic surgery,including 36 patients were in line with the prediction,with 4 patients underwent negative pressure aspiration under ultrasonic monitoring,and 3 patients underwent hysteroscopic surgery+defect repair,with an accuracy of 83.7%(36/43).Among the 7 patients who were predicted to undergo negative pres

关 键 词：剖宫产术 剖宫产后瘢痕妊娠 评分系统 

分 类 号：R714.2[医药卫生—妇产科学]