彩色多普勒超声结合增强型能量多普勒成像诊断胎盘早剥的临床价值探讨

Clinical value of the placental abruption diagnosed by color Doppler ultrasonic combining with enhancement Doppler E-flow imaging

目的探讨彩色多普勒超声结合增强型能量多普勒（E-Flow）成像诊断胎盘早剥，尤其是轻型胎盘早剥的声像图特点，为临床提供有效的诊断依据。方法应用彩色多普勒超声结合E-Flow对50例重型胎盘早剥、23例轻型胎盘早剥的声像图及临床结局进行分析研究。结果50例重型胎盘早剥的彩色多普勒超声结合E—Flow的诊断与临床及产后病理诊断相符，诊断符合率100％；23例轻型胎盘早剥的彩色多普勒超声结合E-FloW的诊断与临床及产后病理诊断符合19例，诊断符合率83％，漏诊、误诊4例（17％）。73例胎盘早剥患者中剖宫产60例，阴道分娩13例。结论增强型能量多普勒超声结合彩色多普勒超声成像技术对重型胎盘早剥的诊断准确率高，为轻型胎盘早剥的诊断提供了新手段，并能动态监测轻型胎盘早剥的转归。

Objective To explore the ultrasonographical characteristics of placental abruption,especially the light placental abruption that was diagnosed by color Doppler ultrasonic combining with enhancement Doppler E-flow imaging, providing diagnosis data for clinical treatment. Methods With color Doppler ultrasonic and enhancement Doppler E-flow imaging,an analysis was made on the ultrasonography and clinical result of 50 patients with heavy placental abruption and 23 patients with light placental abruption. Results The diagnosis and clinical treatment of 50 patients with heavy placental abruption who had been diagnosed by color Doppler ultrasonic combining with enhancement Doppler E-flow imaging were in conformity with the postnatal pathological diagnosis. The coincidence rate in diagnosis was 100 %. Of 23 patients with light placental abruption who had been diagnosed by color Doppler ultrasonic combining with enhancement E-flow Doppler imaging, 19 cases diagnosis and clinical treatment were in accordance with their postnatal pathological diagnosis and the coincidence rate was 83 % , 4 cases were misdiagnosis and missed diagnosis. Of 73 patients with placental abruption,60 cases were carried out caesarean birth and 13 cases performed natural labor. Conclusion The enhancement Doppler E-flow imaging combining with color Doppler ultra- sonic can accurately diagnose the heavy placental abruption and also provide a new method for the diagnosis of light placental abruption and perform a dynamic monitoring for the treatment transfer result of it.