摘要
目的探讨经阴道彩色多普勒超声诊断子宫瘢痕妊娠患者病灶大小及阻力指数,对子宫瘢痕妊娠患者能做到早期准确诊断并及时进行干预提供一定的理论依据。方法回顾性分析符合纳入标准的子宫瘢痕妊娠患者50例,均行经阴道彩色多普勒超声及穿刺注药治疗,对比患者治疗前、后病灶大小及阻力指数。结果 50例患者中42例为单纯孕囊型,8例为团块型;在单纯孕囊中7例见卵黄囊及胎芽但无胎心搏动,3例见孕囊皱缩变形,8例见卵黄囊但无胎芽及胎心搏动,24例见卵黄囊、胎芽及胎心搏动;团块型患者在二维灰阶中表现为团块于子宫前壁下段回声成混合团块,为海绵状或网格状,分界不清,子宫内膜后移;所有患者治疗前超声可探及孕囊及团块内部丰富的血流信号。治疗后,子宫前壁下段肌层厚度增加,与治疗前差异有统计学意义(P<0.01),而病灶长径、病灶宽径差异无统计学意义(P>0.05);治疗后,患者血人绒毛膜促性腺激素(HCG)明显下降,阻力指数升高,与治疗前差异有统计学意义(P<0.01)。孕囊型患者的住院时间、血HCG降至正常时间及阴道流血时间明显缩短(P<0.01)。结论经阴道彩色多普勒超声能表现子宫瘢痕妊娠的影像学特征,并准确定位及定性诊断。
Objective To explore the lesion size and resistance index of patients with cesarean scar pregnancy （CSP） diagnosed by transvaginal color Doppler ultrasonography, provide a certain theoretical basis for early and accurate diagnosis and timely intervention of CSP patients. Methods Fifty CSP patients meeting the inclusion criteria were analyzed retrospectively, all the patients were treated by transvaginal color Doppler ultrasonography, puncture, and injection. Lesion sizes and resistance indexes before and after treatment were compared. Results Among 50 patients, 42 patients were pure gestational sac type and 8 patients were mass type. Among 42 patients with pure gestational sac type, 7 patients were found with yolk sac and fetal bud, but no fetal heart beat was found; 3 patients were found with contraction and deformation of gestational sac ; 3 patients were found with yolk sac, but no fetal bad and fetal heart beat was found, 24 patients were found with yolk sac, fetal bud, and fetal heart beat. Among 8 patients with mass type, two-dimensional gray scale found mixed echo-masses in anterior wall of the uterus, showing spongy shape or latticed shape, the boundary is not clear, posterior displacement of endometrium was observed. Before treatment, abundant blood flow signals in gestational sac and masses could be detected by ultrasound. After treatment, the thickness of low segment of anterior wall of uterine myometrium thickened, compared with before treatment, there was statistically significant difference （P〈0. 01 ） , but there was no statistically significant difference in long diameter and short diameter of the lesions between before and after treatment （ P〉0. 05 ） . After treatment, the level of serum human ehorionic gonadotropin （hCC） decreased significantly, resistance index increased, compared with before treatment, there were statistically significant differences （P〈0. 01 ） . The hospitalization time, the time for serum hCG return to normal, and vaginal bleeding time shortened significantly in patients with pure gestational sac type （P〈0. 01 ）. Conclusion Transvaginal color Doppler ultrasonography can show the imaging features of CSP, the location and property of lesions can be diagnosed accurately.
作者
伍明月
刘雪玲
WU Ming-Yue, LIU Xue-Ling.(Department of Ultrasound, the Second Affiliated Hospital of Guilin Medical College, Guilin, Guangxi 541199, Chin)
出处
《中国妇幼保健》
CAS
2018年第7期1657-1659,共3页
Maternal and Child Health Care of China
关键词
瘢痕子宫
经阴道超声
妊娠
阻力指数
Scar uterus
Transvaginal ultrasound
Pregnancy
Resistance index
