摘要
目的:探讨产前超声评分预测中央型前置胎盘合并胎盘植入的临床价值。方法:选择2019年1月~2023年2月本院收治的75例中央型前置胎盘患者为研究对象,均行产前超声检查,以产后病理检查结果作为诊断胎盘植入依据,将其划分为胎盘植入组和未植入组,对超声评分诊断的检出率进行观察,并且比较分析植入组和未植入组的妊娠结局、剖宫产次数、年龄以及超声声像图特点等各项指标。结果:本组75例患者,超声预测合并植入40例,未植入35例,手术病理诊断30例合并胎盘植入,45例未合并胎盘植入,超声评分与病理比较无明显差异(P>0.05);植入组的胎盘后间隙消失、胎盘增厚、宫颈膨大以及子宫肌层<2mm所占比例均高于未植入组(P<0.05);植入组的剖宫产次数≥2次、子宫切除、年龄≥35岁以及产后出血率均高于未植入组(P<0.05);ROC曲线分析,超声征象评分的最佳分界点为6分,超声征象评分法诊断胎盘植入的ROC曲线下面积(AUC)和95%CI分别为0.862、0.806~0.918。结论:在中央型前置胎盘合并胎盘植入患者的临床诊断中,产前超声评分系统具有较高的准确率,并且具有无创性、价格便宜以及可重复性好等诸多优点,可以作为产前预测胎盘植入的一种安全、有效的检查方法。
Objective:To investigate the clinical value of prenatal ultrasonography in the diagnosis of dangerous placenta previa with placenta accreta.Methods:75 patients with dangerous placenta previa admitted to our hospital from January 2019 to February 2023 were selected as the research objects,all of whom underwent prenatal ultrasound examination.Then,the results of postpartum pathological examination were taken as the basic basis,and they were divided into placenta implantation group and non-implantation group,and the detection rate of ultrasonic diagnosis was observed.The pregnancy outcome,the number of cesarean sections,age and imaging characteristics of the implanted group and the non-implanted group were compared and analyzed.Results:Among the 75 patients in this group,ultrasound prediction combined with implantation in 40 cases,no implantation in 35 cases,surgical pathological diagnosis combined with placenta implantation in 30 cases,45 cases without placenta implantation,there was no significant difference between ultrasound score and pathology(P>0.05).Postplacental space disappearance,placental thickening,cervical enlargement and myometrium<2mm in the implantation group were higher than those in the non-implantation group(P<0.05).The number of cesarean section≥2,hysterectomy,age≥35 years and postpartum hemorrhage rate in the implantation group were higher than those in the non-implantation group(P<0.05).ROC curve analysis showed that the best dividing point of ultrasonic sign score was 6 points,and the area under ROC curve(AUC)and 95%CI of ultrasonic sign score for the diagnosis of placenta implantation were 0.862 and 0.806-0.918,respectively.Conclusion:In the clinical diagnosis of patients with dangerous placenta previa complicated with placenta accreta,ultrasonic examination has high accuracy,non-invasive,cheap and reproducible,and can be used as a safe and effective examination method.
作者
于媛媛
尤淑艳
翟晶
李玉岩
YU Yuan-yuan;YOU Shu-yan;ZHAI Jing;LI Yu-yan(Ultrasonic Department of Dalian Women and Children’s Medical Center(Group),Liaoning Dalian 116000;Obstetrics Ward of Dalian Women and Children’s Medical Center(Group),Liaoning Dalian 116000)
出处
《中国医疗器械信息》
2024年第2期137-139,共3页
China Medical Device Information
关键词
产前超声
胎盘植入
中央型前置胎盘
prenatal ultrasound
placenta accreta
placenta previa pernicious
