半定量CT评分在内生型剖宫产瘢痕部位妊娠诊疗中应用初探

Preliminary study on the application of semi quantitative CT score in the diagnosis and treatment of cesarean scar pregnancy

目的:初步探讨半定量CT评分在内生型剖宫产瘢痕部位妊娠(cesarean scar pregnancy,CSP)诊疗中的应用价值。方法:回顾性分析78例内生型剖宫产瘢痕部位妊娠患者的临床及影像资料。将依据半定量CT评分制定治疗方案的患者归入CT组,CT评分依据为孕囊植入深度和CSP血供丰富程度。将依据超声诊断制定治疗方案的患者归入对照组。比较两组患者术中的出血量及大出血发生率。结果:53例归入CT组,术中出血量为(29.43±28.62)ml,无大出血病例。25例归入对照组,术中出血量为(292.60±520.84)ml,其中3例发生大出血。CT组术中出血量及大出血发生率明显低于对照组,差异均有统计学意义(P<0.01)。结论:半定量CT评分对内生型剖宫产瘢痕部位妊娠临床诊疗策略的制定具有重要的参考价值。

Objective： To preliminarily explore the clinical value of semi-quantitative CT scoring for the evaluation of the diagnosis and treatment of endogenous cesarean scar pregnancy. Methods： 78 cases with endogenous cesarean scar pregnancy were retrospectively analyzed with clinical data and images. Cases with treatment plans referred to CT scoring were classified as the CT group; CT scoring depending on the depth of the gestational sac implanted as well as the abundant of the CSP blood supply. Those referred to ultrasonography were classified as the control group. The amount of intraoperative bleeding and incidence of hemorrhage were compared between the two groups.Results： The CT group included 53 cases,with an average amount of bleeding of（ 29. 43 ± 28. 62） ml during operation and had no incidence of hemorrhage. The control group had an average value of（ 292. 60 ± 520. 84） ml,of which 3 cases experienced hemorrhage. The CT group had a significantly less amount of intraoperative bleeding and lower incidence of hemorrhage than the control group,which has a statistical significance（ P〈0. 01）. Conclusion： Semi-quantitative CT scoring can provide effective clinical treatment strategy for endogenous cesarean scar pregnancy.