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目的探讨经阴道彩色多普勒超声诊断剖宫产切口瘢痕妊娠临床价值,为临床诊断提供依据。方法回顾性分析2014年6月-2016年10月48例接受孕检的疑似剖宫产切口瘢痕妊娠患者的临床资料,分析患者经阴道彩色多普勒超声图像特点。结果 48例疑似剖宫产切口瘢痕妊娠患者经多普勒超声检查后,41例确诊为瘢痕妊娠,病理确诊40例,准确率97.56%,7例患者为非瘢痕妊娠,病理确诊6例,准确率85.71%,总体临床诊断准确率为95.83%;瘢痕妊娠患者分为孕囊型和包块型两种,两种类型患者彩色多普勒超声检查图像显示病灶存在一定的差异,临床诊断可根据超声图像特点进行确诊;41例剖宫产切口瘢痕妊娠患者治疗前后病灶大小(长、宽)差异无统计学意义(P>0.05),子宫前壁峡部肌层厚和动脉血流阻力指数显著增加(P<0.05)。结论经阴道彩色多普勒超声在剖宫产瘢痕妊娠患者临床诊断上可提供相对较精确的病灶图像,对疾病诊断和治疗有较大的临床价值。
Objective To investigate the clinical value of transvaginal color Doppler sonography in the diagnosis of cesarean scar incision pregnancy and provide the basis for clinical diagnosis. Methods The clinical data of 48 pregnant women with suspected cesarean section scar pregnancy undergoing pregnancy test from June 2014 to October 2016 were analyzed retrospectively. The characteristics of transvaginal color Doppler ultrasonography were analyzed. Results 48 cases of suspected cesarean scar incision pregnancy after Doppler ultrasound examination, 41 cases were diagnosed as scar pregnancy, pathological diagnosis of 40 cases, the accuracy rate of 97.56%, 7 cases of non-scar pregnancy, the pathological diagnosis of 6 cases, accurate Rate of 85.71%, the overall clinical diagnostic accuracy was 95.83%; scar pregnancy patients were divided into gestational sac and mass two types of color Doppler ultrasound images showed two different types of lesions there are some differences in clinical diagnosis can be based on (P> 0.05). The thickness of the anterior wall of the isthmus and the index of arterial blood flow resistance were significantly increased in 41 cases of cesarean scar pregnancy patients before and after treatment (P <0.05). Conclusion Transvaginal color Doppler ultrasound in cesarean scar pregnancy clinical diagnosis can provide relatively accurate images of the lesion, the diagnosis and treatment of disease have greater clinical value.