彩色多普勒超声评价子宫动脉化疗栓塞联合清宫术治疗瘢痕妊娠的价值

SIGNIFICANCE OF COLOR DOPPLER ULTRASONOGRAPHY IN THE SCAR PREGNANCY TREATED WITH UTERINE ARTERIAL CHEMOEMBOLIZATION COMBINED WITH SUCTION CURETTAGE

目的探讨彩色多普勒超声在子宫动脉化疗栓塞联合清宫术治疗瘢痕妊娠中的价值。方法回顾性分析彩色多普勒超声在42例因瘢痕妊娠行子宫动脉化疗栓塞联合清宫术的术前诊断价值、栓塞术后的疗效评价、超声引导下清宫及术后随访中的作用。结果 36例表现为子宫前壁下段厚壁囊性结构,其中25例可见孕囊呈"泪滴"形,6例表现为子宫前壁下段囊实混合回声或实性包块。子宫动脉化疗栓塞后,72h内表现为病灶体积不同程度的缩小,血流信号明显减少或消失。超声引导下均一次性清宫成功。超声随访平均32d子宫恢复正常,11例可见瘢痕处憩室。结论彩色多普勒超声可以准确诊断CSP、评价子宫动脉栓塞的疗效、引导清宫及术后针对性随访,值得大力临床推广。

Objective To investigate the application value of color doppler ultrasonography in the therapy for cesarean scar pregnancy treated with bilateral uterine arterial chemoembolization combined with suction curettage.Methods Ultrasonographic data were retrospectively analyzed in 42 patients with cesarean scar pregnancy before and after uterine arterial chemoembolization,for evaluation of curative efficiency,ultrasound-guided suction curettage and follow-up.Results Embryo was detected in the lower uterine incision scar on the anterior cesarean section in 36 cases,while 25 cases of them showed ＂tears＂ shape.Mixed mass was detected at the anterior segment of uterine in6 cases.In72 h after bilateral uterine arterial chemoembolizationm,the lesions size reduced in various degrees and had rare blood flows or no blood flows.Ultrasound successfully guided uterine curettage operation and followed up until masses disappeared in 32 days,cesarean scar defects was detected in 11 cases.Conclusion Color doppler ultrasound may precisely diagnose cesarean scar pregnancy and play an important role in evaluating the curative effect of uterine arterial chemoembolization,ultrasound-guided suction curettage and follow-up.The color doppler ultrasonography should be used as a common method for the clinic.