经腹联合经阴道彩超检查诊断剖宫产子宫瘢痕妊娠的临床价值

The Clinical Value of Transabdominal Combined with Transvaginal Color Doppler Ultrasound in the Diagnosis of Cesarean Section Uterine Scar Pregnancy

目的探讨经腹联合经阴道彩超检查诊断剖宫产子宫瘢痕妊娠的临床价值。方法选取2017年6月—2019年9月丰县人民医院彩超室75例剖宫产子宫瘢痕妊娠患者,患者均采用经腹、经阴道彩超检查,观察患者诊断准确性及误诊情况;孕囊型、包块型检出情况。结果联合检查准确性(89.33%)高于经腹准确性(77.33%),差异有统计学意义(χ^(2)=3.888,P=0.049);联合检查中,3例误诊为不全流产,5例误诊为宫颈妊娠;经腹检查中,9例误诊为宫颈妊娠,5例不全流产,3例先兆流产;经腹检查,孕囊型检出率与病理结果差异无统计学意义(χ^(2)=0.240,P=0.624),但包块型检出率明显低于病理结果,差异有统计学意义(χ^(2)=5.510,P=0.019);经腹联合经阴道对孕囊型、包块型的检出率与病理结果比较,差异无统计学意义(χ^(2)=0.000、3.765,P=1.000、0.052)。结论经腹联合经阴道彩超检查诊断剖宫产子宫疤痕妊娠具有较高准确性。

Objective To explore the clinical value of transabdominal combined with transvaginal color Doppler ultrasound in the diagnosis of cesarean section uterine scar pregnancy.Methods From June 2017 to September 2019,75 patients with cesarean section and uterine scar pregnancy were selected from the color Doppler ultrasound room of Fengxian People's Hospital.All patients were examined by transabdominal and transvaginal color Doppler ultrasound to observe the diagnosis accuracy and misdiagnosis of the patients;gestational sac type,the detection status of the lump type.Results The accuracy of the combined examination(89.33%)was higher than that of the transabdominal(77.33%),and the difference was statistically significant(χ^(2)=3.888,P=0.049);in the combined examination,3 cases were misdiagnosed as incomplete abortion,5 cases were misdiagnosed as cervical pregnancy;in transabdominal examination,9 cases were misdiagnosed as cervical pregnancy,5 cases were incomplete miscarriage,3 cases were threatened abortion;transabdominal examination,the rate of gestational sac type detection was not significantly different from the pathological results(χ^(2)=0.240,P=0.624),but the detection rate of the mass type was significantly lower than the pathological results,and the difference was statistically significant(χ^(2)=5.510,P=0.019);transabdominal combined transvaginal pregnancy compared with the pathological results,the detection rate of cystic and mass type was not statistically significantly different(χ^(2)=0.000,3.765,P=1.000,0.052).Conclusion The combination of transabdominal and transvaginal color Doppler ultrasound in the diagnosis of cesarean section uterine scar pregnancy has high accuracy.