彩色多普勒超声在子宫瘢痕妊娠诊断和治疗中的价值体会

Value of Color Doppler Ultrasound in Diagnosis and Treatment of Uterine Scar Pregnancy

目的:分析在剖宫产术后子宫瘢痕妊娠诊治中应用彩色多普勒超声的临床价值。方法:纳入子宫瘢痕妊娠患者80例(收治时间为2018年6月~2020年1月),所有患者均实施剖宫产手术,并在术后进行诊断和治疗。分组原则为随机数字表法,各40例。对照组:经腹部彩色多普勒超声,观察组:经阴道彩色多普勒超声。观察和比较两组的应用效果。所有患者均在彩色多普勒超声诊断指导下接受保守治疗和手术治疗,观察患者治疗前后RJ值和血β-hCG值的变化,以为彩色多普勒超声在子宫瘢痕妊娠患者治疗中的价值提供依据。结果:相比对照组,观察组检出率(95.00%,75.00%)和符合率(92.50%,72.50%)更有优势,P<0.05;其中观察组单纯妊娠囊型25例,占比62.50%;宫腔型7例,占比17.50%,与临床最终确诊结果相符合。同时,通过对患者超声图像的分析,可以看出,愈合型子宫妊娠有混合型10例(12.50%),32例(40.00%)患者为异质性肿块型,38例(47.50%)为胚囊型。结论:临床诊治剖宫产术后子宫瘢痕妊娠应用彩色多普勒超声的效果突出,对于指导患者的有效治疗,作用更明显。

Objective:To analyze the clinical value of color Doppler ultrasound in the diagnosis and treatment of uterine scar pregnancy after cesarean section.Methods:80 patients with uterine scar pregnancy(admitted from June 2018 to January 2020)were included.All patients underwent cesarean section,and were diagnosed and treated after surgery.The principle of grouping was random number table method,with 40 cases in each group.Control group:transabdominal color Doppler ultrasound,observation group:transvaginal color Doppler ultrasound.Observe and compare the application effect of the two groups.All patients received conservative treatment and surgical treatment under the guidance of color Doppler ultrasound diagnosis,and the changes of RJ value and blood β-HCG value were observed before and after treatment,so as to provide evidence for the value of color Doppler ultrasound in the treatment of patients with uterine scar pregnancy.Results:Compared with the control group,the detection rate(95.00%,75.00%)and coincidence rate(92.50%,72.50%)in the observation group were more advantageous(P<0.05);In the observation group,there were 25 cases of simple gestational sac,accounting for 62.50%;There were 7 cases of uterine cavity type,accounting for 17.50%,which was consistent with the final clinical diagnosis.At the same time,through the analysis of the ultrasound images of the patients,it can be seen that there are 10 cases(12.50%)of mixed uterine pregnancy and 32 cases(40.00%)of heterogeneous mass,and 38 cases(47.50%)were embryo sac type.Conclusion:The clinical diagnosis and treatment of uterine scar pregnancy after cesarean section is effective with color Doppler ultrasound.It plays a more obvious role in guiding the effective treatment of patients.