子宫切口瘢痕妊娠超声诊断价值.doc

子宫切口瘢痕妊娠超声诊断价值 　　[摘要] 目的 探讨剖宫产术后子宫切口瘢痕妊娠的超声诊断价值。 方法 选取重庆市南川区妇幼保健院2010年2月～2014年3月收诊的30例剖宫产术后子宫下段瘢痕切口妊娠患者的超声声像图特征做回顾性分析。仪器和方法使用飞利浦彩超诊断仪，采用经阴道及经腹超声联合扫查，主要采用经阴道超声扫查，探头频率5.5～7.0MHz；经腹扫查为辅助扫查，主要观察瘢痕妊娠位置与子宫下段、宫体、宫颈的关系。常规扫查子宫、宫腔、双侧附件及盆腔。经阴道彩超可清晰显示子宫下段切口的位置，主要扫查子宫峡部（切口）处有无异常回声（妊娠物），确定妊娠物与子宫下段切口瘢痕的关系，观察妊娠物的形态、回声、大小、局部血流滋养情况，并测量其与子宫浆膜层之间的厚度。 结果 30例子宫切口妊娠病例中，诊断符合26例，误诊2例，漏诊2例，诊断正确率86%。 结论 经阴道彩超对子宫切口妊娠的诊断是一种可靠的诊断方法，能明确妊娠囊着床位置，具有重要的临床价值，值得在子宫瘢痕妊娠临床治疗中推广应用。 　　[关键词] 子宫切口妊娠；瘢痕妊娠；超声；诊断 　　[中图分类号] R445.2；R719.8 [文献标识码] B [文章编号] 2095-0616（2015）15-176-04 　　[Abstract] Objective To investigate the value of ultrasound in the diagnosis of uterine incision scar pregnancy after cesarean section. Methods The ultrasonographic features of 30 cases of cesarean section scar pregnancy after cesarean section were selected from February 2010 to March 2014.Apparatus and method for using Philips color Doppler diagnostic instrument，using transvaginal and transabdominal ultrasound combined scanning，the main use of transvaginal ultrasound scan and probe frequency 5.5-7.0MHz；The transabdominal assisted scanning，mainly to observe scar pregnancy uterine position and relationship under section，uterine body and cervix.Routine scan of the uterus，uterine cavity，bilateral annex and pelvis.By transvaginal color Doppler ultrasound can clearly display the location of the incision of lower uterine segment，mainly sweep check uterine isthmus （incision） at have no abnormal echo （pregnancy），determine the pregnancy and uterine incision scar relationship，pregnancy shape，echo，size，local blood nourishment situation observation and measurement with serosal layer between the thickness. Results In 30 cases of uterine incision pregnancy，the diagnosis was in line with 26 cases，misdiagnosed in 2 cases，missed diagnosis in 2 cases，the diagnosis rate was 86%. Conclusion The diagnosis of transvaginal color Doppler sonography in the diagnosis of uterine incision pregnancy is a reliable diagnostic method， can be clear about the preg