3D玻璃体超声成像结合宫腔镜检查在瘢痕妊娠中的应用

Application value of three dimensional glass ultrasonic imaging combined with hysteroscopy in diagnosis and treatment of cesarean scar pregnancy

目的探3D玻璃体超声成像技术结合宫腔镜检查术在瘢痕妊娠中的诊断及治疗应用。方法选择2015年10月至2020年1月就诊既往有剖宫产史,要求终止妊娠患者共230例。根据治疗方法不同,将其分为对照组100例和观察组130例,观察组使用3D玻璃体超声成像和宫腔镜检查技术,对照组仅使用3D玻璃体超声成像技术。2组均留取术前及术后3D玻璃体超声成像图,血管化指数(VI)血流指数(FI)血管化血流指数(VFI)、人绒毛膜促性腺激素(β-HCG)。结果观察组和对照组年龄、停经时间,距离上次剖宫产时间差异无统计学意义(P>0.05);观察组术前VI、FI、VFI明显高于对照组(P<0.05),术后差异无统计学意义(P>0.05);β-HCG术前术后差异无统计学意义(P>0.05);3D玻璃体成像技术结合宫腔镜检查术诊断一致性高于单独3D玻璃体超声成像(P<0.05)。结论3D玻璃体超声成像技术结合宫腔镜检查术是一种定量及定性相结合的检查和治疗手段,临床诊断符合率较高,有助于临床选择合适的治疗方案,降低不良妊娠结局。

Objective To investigate the application value of three dimensional glass ultrasonic imaging combined with hysteroscopy in diagnosis and treatment of cesarean scar pregnancy.Methods A total of 230 pregnant women,who once underwent cesarean section and asked for termination of pregnancy in our hospital from October 2015 to January 2020,were divided into observation group(n=130)and control group(n=100).The pregnant women in control group underwent 3D glass ultrasonic imaging only,however,the pregnant women in observation group underwent 3D glass ultrasonic imaging and hysteroscopy.The 3D glass ultrasonic images,vascularization index(VI),blood flow index(FI),vascularization flow index(VFI)and the levels ofβHCG before and after operation were observed and compared between the two groups.Results There were no significant differences in age,menopause time and caesarean interval time between the groups(P>0.05).The VI,FI and VFI before operation in observation group were significantly higher than those in control group(P<0.05),however,after operation there were no significant differences between the two groups(P>0.05).Moreover,there were no significant differences in HCG levels before and after operation(P>0.05).In addition,diagnostic consistency of 3dimensional glass ultrasound combined with hysteroscopy was significantly higher than that by three dimensional glass ultrasound only(P<0.05).Conclusion The three dimensional glass ultrasonic imaging combined with hysteroscopy is a combined quantitation and qualitation detection and treatment way,and its clinical diagnostic consistency is higher,which is helpful to choose better therapeutic scheme and reduce adverse pregnancy outcomes.