摘要
目的:分析产前超声诊断仪对胎盘植入的诊断价值及影响因素。方法:回顾性收集行产前超声检查及分娩或引产的72例疑似胎盘植入患者的诊治资料,以手术和病理诊断结果为标准,分析产前超声对胎盘植入的诊断价值及产前超声诊断的影响因素。结果:产前超声发现胎盘植入患者29例,其灵敏度、特异度和准确率分别为75.67%、97.14%和86.11%;29例患者中有胎盘信号不均、胎盘后间隙消失、胎盘内漩涡形成、胎盘附着子宫肌层变薄及胎盘异常增厚征象均高于无胎盘植入的患者,差异有统计学意义(x^2=25.664,x^2=18.025,x2=24.452,x^2=22.172,x^2=17.854;P<0.05)。胎盘植入患者产前超声对合并前置胎盘者检出率为94.44%,高于无前置胎盘者的60.71%;合并前壁胎盘者检出率为100.00%,高于无前壁胎盘者的66.67%;产后出血者检出率为93.75%,高于无产后出血者的61.90%;有资深诊断经验的医师检出率为86.96%,高于无资深诊断经验医师的57.14%,差异均有统计学意义(x^2=6.708,x^2=4.405,x^2=5.003,x^2=4.202;P<0.05)。结论:产前超声诊断有助于提高胎盘植入的诊断效能,前置胎盘、前壁胎盘、产后出血及医师诊断经验均可影响超声诊断结果。
Objective:To analyze the diagnostic value and influence factors of prenatal ultrasonic diagnosis apparatus for placenta implantation.Methods:The data of diagnosis and treatment of 72 patients with suspected placenta implantation who underwent prenatal ultrasound and delivery or induced labour were retrospectively collected.The results of surgery and pathological diagnosis were used as standard to analyze the diagnostic value of prenatal ultrasound on placenta implantation and the influence factors of prenatal ultrasound diagnosis.Results:29 positive cases were found by prenatal ultrasound,and its sensitivity,specificity and accuracy were 75.67%,97.14%and 86.11%,respectively.In positive patients with placenta implantation detected by ultrasound,the proportion of patients with symptoms such as uneven placental signal,disappearance of the posterior placental space,formation of vortex in placenta,thinning of the myometrium that attached to the placenta and abnormal thickening of placenta was significantly higher than that of negative patients(x^2=25.664,x^2=18.025,x^2=24.452,x^2=22.172,x^2=17.854,P<0.05),respectively.By prenatal ultrasound,the relevance ratio of patients whose placenta implantation combined with placenta previa was 94.44%,which was higher than that(60.71%)of patients who were placenta implantation without placenta previa.The relevance ratio of patients whose placenta implantation combined with antetheca placenta was 100.00%,which was higher than that(66.67%)of patients who were placenta implantation without antetheca placenta.The relevance ratio of patients with postpartum hemorrhage was 93.75%,which was higher than that(61.90%)of those without postpartum hemorrhage.The relevance rate of physicians with senior diagnostic experience was 86.96%,which was higher than that(57.14%)of physicians without senior diagnostic experience.And all of these differences had statistical significance(x^2=6.708,x^2=4.405,x^2=5.003,x^2=4.202,P<0.05).Conclusion:The prenatally ultrasonic diagnosis contributes to improve the diagnostic efficiency for placenta implantation.The placenta previa,antetheca placenta,postpartum hemorrhage and diagnostic experience of physicians all can influence the diagnostic results.
作者
颜雪萍
韩春苗
吴青京
陈昌钊
YAN Xue-ping;HAN Chun-miao;WU Qing-jing(Department of Ultrasound,Hainan Maternal and Child Health Care Hospital,Haikou 570206,China)
出处
《中国医学装备》
2019年第10期63-66,共4页
China Medical Equipment
关键词
超声诊断仪
胎盘植入
诊断
影响因素
Ultrasound diagnostic apparatus
Placenta implantation
Diagnosis
Influence factor
