超声检查在剖宫产瘢痕妊娠诊断中的应用价值探究

Application value of ultrasonography in the diagnosis of cesarean scar pregnancy

目的探讨剖宫产瘢痕妊娠采用超声检查的诊断价值。方法26例剖宫产瘢痕妊娠患者,均实施经阴道超声、经腹部超声检查。对比经阴道超声与经腹部超声对剖宫产瘢痕妊娠的诊断准确率、剖宫产瘢痕妊娠分型的诊断符合率,不同剖宫产瘢痕妊娠分型患者剩余肌层厚度、孕囊周围血流情况。结果经阴道超声对剖宫产瘢痕妊娠的诊断准确率96.15%明显高于经腹部超声的76.92%,差异具有统计学意义(P<0.05)。经阴道超声与经腹部超声对剖宫产瘢痕妊娠Ⅰ型、Ⅱ型、Ⅲ型的诊断符合率对比,差异无统计学意义(P>0.05)。剖宫产瘢痕妊娠Ⅰ型患者剩余肌层厚度大于Ⅱ型、Ⅲ型患者,且Ⅱ型患者大于Ⅲ型患者,差异具有统计学意义(P<0.05)。结论对剖宫产瘢痕妊娠患者实施超声检查可取得良好诊断效果,且经阴道超声的诊断准确率较经腹部超声更高,可为临床治疗方案制定及疗效评估提供可靠参考,发挥显著的临床应用价值。

Objective To discuss the value of ultrasonography in the diagnosis of cesarean scar pregnancy.Methods All 26 patients with cesarean scar pregnancy underwent transvaginal ultrasonography and transabdominal ultrasonography.Comparison was made on diagnostic accuracy of transvaginal ultrasonography and transabdominal ultrasonography for cesarean scar pregnancy,diagnostic coincidence rate of cesarean scar pregnancy classification,as well as the remaining myometrial thickness,and the blood flow around the gestational sac in patients with different classification of cesarean scar pregnancy.Results The diagnostic accuracy of transvaginal ultrasonography for cesarean scar pregnancy was 96.15%,which was significantly higher than 76.92%of transabdominal ultrasonography,and the difference was statistically significant(P<0.05).There was no statistically significant difference between transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of typeⅠ,ⅡandⅢcesarean scar pregnancy(P>0.05).The remaining myometrial thickness in patients with typeⅠcesarean scar pregnancy was greater than that in patients with typeⅡand typeⅢcesarean scar pregnancy,and patients with typeⅡcesarean scar pregnancy was greater than patients with typeⅢcesarean scar pregnancy,and the differences were all statistically significant(P<0.05).Conclusion Ultrasonography for pregnant women with cesarean scar pregnancy can achieve good diagnostic effect,and the diagnostic accuracy of transvaginal ultrasonography is higher than that of transabdominal ultrasonography,which can provide a reliable reference for formulation of clinical treatment regimen and efficacy assessment,and play a significant clinical application value.