腹部及阴道超声检查对剖宫产术后瘢痕妊娠分型诊断的价值

Diagnostic value of abdominal and vaginal ultrasound for the classifications of cesarean scar pregnancy after cesarean section

目的 分析腹部及阴道超声检查对剖宫产术后瘢痕妊娠(CSP)分型诊断的价值。方法 选取2019年3月-2021年3月本院诊治的86例疑似CSP患者进行研究。所有患者均进行经腹部超声检查及阴道超声检查,将两种检查方式的诊断结果与手术病理结果进行比较,分析两种检查方式诊断CSP患者的情况。结果 86例患者经手术病理检查确诊CSP患者74例,经腹部超声诊断CSP的灵敏度为78.38%、特异度为66.67%、准确率为76.74%,经阴道超声诊断CSP的灵敏度为91.89%、特异度为75.00%、准确率为89.53%,经阴道超声检查诊断CSP的灵敏度、准确率均高于经腹部超声检查(P<0.05);74例CSP患者经手术病理检查确诊瘢痕处孕囊部分突入型40例,瘢痕处孕囊完全突入型25例,混合团块型9例。经阴道超声检查诊断瘢痕处孕囊部分突入型的准确率高于经腹部超声检查(P<0.05),两种检查方法诊断瘢痕处孕囊完全突入型、混合团块型的准确率比较,差异无统计学意义(P>0.05)。结论 经阴道超声检查诊断CSP的临床价值更高,且对瘢痕处孕囊部分突入型的检出情况优于经腹部超声检查。

Objective To analyze the diagnostic value of abdominal and vaginal ultrasound for the classifications of cesarean scar pregnancy(CSP)after cesarean section.Methods A total of 86 patients with suspected CSP treated in the hospital were enrolled between March 2019 and March 2021.All underwent abdominal and vaginal ultrasound examinations.The diagnosis results between the two methods and surgical pathology were compared.Diagnostic efficiency of the two methods for CSP was analyzed.Results Of the 86 patients, there were 74 cases confirmed with CSP by surgical pathology.The sensitivity, specificity and accuracy rates of abdominal ultrasound and vaginal ultrasound in the diagnosis of CSP were(78.38%,66.67%,76.74%)and(91.89%,75.00%,89.53%),respectively.The sensitivity and accuracy rates of vaginal ultrasound were higher than those of abdominal ultrasound(P<0.05).Of the 74 CSP patients, it was confirmed by surgical pathology that there were 40 cases with partial protrusion of gestational sac, 25 cases with complete protrusion and 9 cases with mixed type.The accuracy rate of vaginal ultrasound in the diagnosis of partially protruded gestational sac was higher than that of abdominal ultrasound(P<0.05),but the difference in the accuracy rates between the two methods in the diagnosis of completely protruded gestational sac and the mixed lumps was not not statistically significant(P>0.05).Conclusion Compared with abdominal ultrasound, clinical value of vaginal ultrasound is higher in the diagnosis of CSP.And detection of partially protruded gestational sac by vaginal ultrasound is better than that by abdominal ultrasound.