宫角妊娠超声测量参数及分型与超声引导下清宫术疗效的关系

Analysis of the relationship between ultrasonic parameters and types of cornual pregnancy and therapeutic effect under ultrasound-guided curettage

目的分析宫角妊娠超声测量参数及分型与超声引导下清宫术治疗疗效的关系。方法回顾性分析经我院临床及病理证实的59例宫角妊娠患者,根据超声引导下清宫术治疗情况分为治疗有效者和无效者,比较其声像图分型、病灶最大径及病灶周边肌层厚度。结果清宫治疗有效者44例,无效者15例。子宫内膜环绕型患者中治疗有效者35例,部分内膜包绕型治疗有效者9例,无内膜包绕型治疗均无效,三者治疗有效率分别为100%、100%及0,差异有统计学意义(χ2=42.047,P<0.05);孕囊型患者中治疗有效者34例,团块型治疗有效者10例,两者治疗有效率分别为89.5%和47.6%,差异有统计学意义(χ2=10.387,P<0.05)。治疗有效者和无效者病灶最大径和病灶周边肌层厚度比较差异均有统计学意义(均P<0.05)。结论宫角妊娠患者的超声测量参数及分型对超声引导下清宫术治疗宫角妊娠具有一定的指导意义,宫角妊娠病灶有内膜环绕或病灶为孕囊型的患者,以及宫角妊娠病灶体积较小,周边肌层较厚的患者行超声引导下清宫术治疗效果较好。

Objective To analyze the relationship between ultrasonic parameters and types of cornual pregnancy and the therapeutic effect of ultrasound-guided curettage.Methods Fifty-nine patients with cornual pregnancy confirmed by clinical and pathological findings in our hospital were retrospectively analyzed.They were treated by ultrasound-guided curettage.The patients were divided into effective treatment group and ineffective treatment group.The differences in the types of ultrasonographic images,the maximum diameter of the lesion and the thickness of muscular layer around the lesion between two groups were analyzed.Results There were 44 cases in effective treatment group:35 cases(100%)with endometrial encircling and 9 cases(100%)with partial endometrial encircling,0 cases(0)without endometrium(χ2=42.047,P<0.05).There were 34 effective cases of pregnant sac type and 10 effective cases of lump type,there was significant difference(89.5%vs.47.6%,χ2=10.387,P<0.05).There were significant differences of maximum diameter of lesions and the thickness of muscular layer around the lesions between two groups(all P<0.05).Conclusion The ultrasonic parameters and types of patients with cornual pregnancy have certain guiding significance for the treatment of cornual pregnancy by ultrasound-guided curettage.Patients with endometrium surrounding or gestational sac type lesions of cornual pregnancy,as well as patients with smaller lesions of cornual pregnancy and thicker myometrium around the lesions have better therapeutic effect by ultrasound-guided curettage.