经阴道彩超诊断瘢痕子宫妊娠的临床价值

顾兵

doi：10.3969/j.issn.1007-614x.2014.14.58

摘 要 目的：分析经阴道彩超诊断瘢痕子宫妊娠的临床价值。方法：收治瘢痕子宫妊娠患者52例，作为研究对象，所有患者均分别采取经腹部彩超和经阴道彩超检查，分析其诊断结果。结果：经腹部彩超诊断，诊断符合率73.1%；经阴道超声诊断，诊断符合率92.3%，组间对比差异有统计学意义（P<0.05）。经阴道彩超诊断，混合包块型27例，孕囊型15例，蜂窝型6例。结论：经阴道彩超可有效诊断瘢痕子宫妊娠，具有较高的确诊率，并且可直观显示病变处实际情况，为瘢痕子宫妊娠的治疗提供了必要的参考价值。

关键词 经阴道彩超 瘢痕子宫妊娠 诊断

Clinical value of transvaginal color doppler ultrasound in diagnosis of scar uterine pregnancy

Gu Bing

Special survey division of the third people's hospital in Rudong County，Jiangsu Province，226400

Abstract Objective：To discuss the clinical value of transvaginal color doppler ultrasound in diagnosis of scar uterine pregnancy.Methods：52 cases of patients with scar uterine pregnancy were admited and as the research objects.All cases were respectively adopted abdomen color doppler ultrasound and transvaginal color doppler ultrasound.Then analyze the diagnostic results.Results：The diagnostic accordance rate of abdomen color doppler ultrasound diagnosis was 73.1%，while the diagnostic accordance rate of transvaginal color doppler ultrasound was 92.3%.There was significant difference between the two methods（P<0.05）.In the transvaginal color doppler ultrasound，27 cases were mixed bag piece type，15 cases were pregnant bursa type，and 6 cases were honeycomb type.Conclusion：Transvaginal color doppler ultrasound can effectively diagnose scar uterine pregnancy.It has a high diagnostic rate.It can display the actual situation of the lesion，and provide the necessary reference for the treatment of scar uterine pregnancy.

Key words Transvaginal color doppler ultrasound；Scar uterine pregnancy；Diagnosis

瘢痕子宫妊娠是受精卵或胚胎着床于子宫切口的瘢痕部位，属于特殊的异位妊娠。随着剖宫产率的不断提高，瘢痕子宫妊娠的发生率也不断增加。通常瘢痕子宫妊娠的妊娠物被子宫肌层和纤维瘢痕组织所环绕，若未得到及时有效治疗，会导致患者出现子宫破裂，乃至大出血，严重者可致死亡。据相关资料显示，瘢痕子宫妊娠早期无明显特征，在诊断时易漏诊和误诊，给患者的生命安全造成严重影响[1]。笔者以52例瘢痕子宫妊娠患者作为研究对象，分析经阴道彩超的诊断价值，现报告如下。

资料与方法

2009年8月-2014年2月收治瘢痕子宫妊娠患者52例，年龄24～36岁，平均年龄（28.5±1.2）岁；患者均有剖宫产史；患者均出现过不同程度的阴道不规则流血；排除子宫肌瘤等病变患者，伴心、脑、肝等器质性疾病患者；患者均知情同意此次研究。

检测仪器：GE LOGIQ 3.0 PRO彩色多普勒诊断仪，腹部探头频率3.5MHz，阴道探头频率5.5～7.5MHz。……