彩色多普勒超声检查诊治剖宫产术后子宫瘢痕妊娠的临床应用价值研究

Clinical Value of Color Doppler Ultrasonography in Diagnosis and Treatment of Uterine Scar Pregnancy After Cesarean Section

目的:分析彩色多普勒超声检查诊治剖宫产术后子宫瘢痕妊娠的临床应用价值。方法:以本院2018年1月~2021年5月纳入的100例剖宫产术后子宫瘢痕妊娠患者为例展开研究,全部安排其开展经阴道彩色多普勒超声检查,并且于超声引导下予以穿刺用药治疗,根据病理学检查结果作为金标准,观察彩色多普勒超声诊断检查的确诊率以及误诊率,同时根据超声声像图表现对100例患者进行分型,对比不同分型患者彩色多普勒血流显像(CDFI)血流信号丰富程度差异并且观察100例患者治疗效果。结果:彩色多普勒超声检查的确诊率为94.00%,漏诊率为6.00%。100例患者彩色多普勒超声显像显示妊娠囊周边均能够看到来自子宫切口肌层的血流信号,同时血流信号丰富程度会随着患者累及肌层以及浆膜层程度的加深而不断增加,根据CDFI图像分型显示Ⅰ型、Ⅱ型、Ⅲ型患者分别32例、49例和19例。Ⅰ型、Ⅱ型、Ⅲ型有血流信号和有丰富血流信号患者分别占比28.13%和71.87%、24.49%和75.51%、21.05%和78.95%。100例患者经过治疗后,其人绒毛膜促性腺激素水平较治疗前显著降低,动脉血流阻力指数较治疗前显著降低,同时子宫前壁下段肌层厚度较治疗前显著增加(P<0.05)。结论:在剖宫产术后子宫瘢痕妊娠患者的诊治中,彩色多普勒超声检查诊治价值显著,不仅诊断准确性高,而且还可以准确分析患者血供、妊娠囊以及肌层分级等,能够为临床治疗带来良好的指导作用,使患者的临床治疗更加合理。

Objective:To analyze the clinical value of color Doppler ultrasound in diagnosis and treatment of uterine scar pregnancy after cesarean section.Methods:This study took 100 cases of patients with uterine scar pregnancy after cesarean section included in our hospital from January 2018 to May 2021 as examples.All of them were arranged to receive transvaginal color Doppler ultrasound examination,and ultrasound-guided puncture medication treatment.The pathological examination results were taken as the gold standard.The diagnosis rate and misdiagnosis rate of color Doppler ultrasonography were observed.At the same time,100 patients were classified according to the ultrasonography performance,and the difference of blood flow signal richness of different types of patients with color Doppler flow imaging(CDFI)was compared,and the treatment effect of 100 patients was observed.Results:The diagnostic rate of color Doppler ultrasonography was 94.00%,and the missed diagnosis rate was 6.00%.100 cases of patients with color Doppler ultrasonography showed gestational sac surrounding can see blood flow signals from the uterine incision muscle layer,rich blood flow signal level at the same time with the patient involvement degree of muscularis and serosa layer and continue to increase,according to the type of a CDFI images points shown in patients with type I,II,III 32 cases,49 cases and 19 cases.Patients with blood flow signal or rich blood flow signal in type I,II and III accounted for 28.13%and 71.87%,24.49%and 75.51%,21.05%and 78.95%.After treatment in 100 patients,the level of human chorionic gonadotropin was significantly lower than that before treatment,the arterial blood flow resistance index was significantly lower than that before treatment,and the thickness of myometrium of the lower segment of the anterior uterine wall was significantly higher than that before treatment(P<0.05).Conclusion:In the diagnosis and treatment of patients with uterine scar pregnancy after cesarean section,the value of diagnosis and treatment of color Doppler ultrasound examination,not only high diagnostic accuracy,and can be accurate analysis of patients’blood supply,gestational sac and muscular layer classification,etc.,can bring a good guidance for clinical treatment,the clinical treatment of patients is more reasonable.