经阴道超声与经腹部超声诊断剖宫产切口部妊娠的效果研究

Effect of Transvaginal Ultrasonography and Transabdominal Ultrasonography in the Diagnosis of Incision Pregnancy in Cesarean Section

目的探讨对剖宫产切口部妊娠患者分别实施经阴道超声以及经腹部超声诊断的临床价值。方法选取2020年3月—2022年4月枣庄市中医医院收治的60例疑似剖宫产切口部妊娠患者为研究对象,均实施经阴道超声检查和经腹部超声检查,将临床综合诊断结果为依据,比较两种检查方法的诊断效能以及不同类型超声诊断符合率。结果临床综合诊断结果发现,阳性55例,阴性5例,经阴道超声检查的诊敏感度、准确度分别为96.36%(53/55)、95.00%(57/60),高于经腹部超声检查的74.55%(41/55)、70.00%(42/60),差异有统计学意义(χ^(2)=10.083、13.067,P<0.05);经临床综合诊断结果发现,妊娠囊部分突入型、妊娠囊完全突入型以及混合团块型患者例数分别为25例、12例以及18例,经阴道超声检查妊娠囊部分突入型、妊娠囊完全突入型符合率与经腹部超声检查比较,差异无统计学意义(P>0.05)。结论经阴道超声较经腹部超声诊断方法可获得更高诊断效能,可对孕囊类型以及位置准确判断,为临床医师个体化治疗方案研究提供有力依据,将剖宫产切口部妊娠患者的预后水平显著提升。

Objective To investigate the clinical value of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of pregnancy patients with cesarean section incision.Methods Selected 60 patients with suspected cesarean incision pregnancy admitted in the Zaozhuang Hospital of Traditional Chinese Medicine from March 2020 to April 2022,transvaginal ultrasound and transabdominal ultrasound were performed.Based on the comprehensive clinical diagnosis results,the diagnostic efficacy of the two examination methods and the diagnostic concordance rate of different types of ultrasound were compared Results Comprehensive clinical diagnostic results found that 55 positive patients and 5 negative patients,the diagnostic sensitivity and accuracy of transvaginal sonography were 96.36%(53/55),95.00%(57/60),higher than 74.55%(41/55),70.00%(42/60)of transabdominal ultrasound examination was performed,the difference was statistically significant(χ^(2)=10.083,13.067,P<0.05).According to the comprehensive clinical diagnosis results,the number of patients with partial penetration,complete penetration and mixed mass type were 25 cases,12 cases and 18 cases,respectively,transvaginal ultrasound coincidence rates of partial gestational sac,complete gestational sac were compared with transabdominal ultrasound,the difference was not statistically significant(P>0.05).Conclusion Compared with transabdominal ultrasound,transvaginal ultrasound can achieve higher diagnostic efficacy,accurately judge the type and location of pregnancy sac,provide a strong basis for clinicians to study the individualized treatment plan,and significantly improve the prognosis level of pregnant patients in the incision section of cesarean section.