超声参数与瘢痕妊娠分型的关联性及诊断价值研究

Study on the correlation and diagnostic value of ultrasound parameters with the classification of scar pregnancy

目的 探讨超声参数与瘢痕妊娠分型的关联性及诊断价值。方法 选取2021年10月~2022年12月河北省衡水市第二人民医院73例CSP患者设为研究组,另选取同期正常妊娠女性73例设为对照组。两组受检者均接受TVS检查,统计研究组与对照组、研究组不同CSP分型患者超声检查参数[瘢痕肌层厚度(CSM)、子宫下段前壁血流阻力指数(RI)、最小矢状肌厚度],分析超声检查参数与CSP分型的关联性,并比较各参数对CSP的单独及联合诊断效能。结果 研究组CSM、RI、最小矢状肌厚度低于对照组(P<0.05)。不同CSP患者CSM、RI、最小矢状肌厚度间存在显著差异(P<0.05);多重比较,Ⅱ型CSP患者CSM、RI、最小矢状肌厚度低于Ⅰ型CSP患者,Ⅲ型CSP患者CSM、RI、最小矢状肌厚度低于Ⅱ型CSP患者(P<0.05)。CSM、RI、最小矢状肌厚度与CSP疾病分型存在显著负相关关系(P<0.05)。CSM、RI及最小矢状肌厚度联合诊断CSP的AUC为0.719%,大于CSM、RI及最小矢状肌厚度单独诊断的0.706、0.660、0.625。结论 CSP经超声检查可见明显异常,不同CSP分型患者各检查参数存在显著差异,两者具有紧密相关性,临床可通过超声检查对疾病进行诊断评估。

Objective To explore the correlation and diagnostic value of ultrasound parameters with the classification of scar pregnancy.Methods From October 2021to December 2022,73CSP patients in our hospital were selected as the study group,and 73normal pregnant women in the same period were selected as the control group.The subjects in both groups were examined by TVS.The ultrasound parameters of patients with different CSP types in the study group,the control group and the study group[scar muscle thickness(CSM),the anterior wall blood flow resistance index(RI)of the lower segment of the uterus,and the minimum sagittal muscle thickness]were counted,and the correlation between the ultrasound parameters and the CSP types was analyzed,and the individual and combined diagnostic efficacy of each parameter on CSP was compared.Results The CSM,RI and minimum sagittal muscle thickness in the study group were lower than those in the control group(P<0.05).There were significant differences in CSM,RI and minimum sagittal muscle thickness among patients with different CSP(P<0.05).Multiple comparison showed that the thickness of CSM,RI and minimum sagittal muscle in typeⅡCSP patients was lower than that in typeⅠCSP patients,and the thickness of CSM,RI and minimum sagittal muscle in typeⅢCSP patients was lower than that in typeⅡCSP patients(P<0.05).There was a significant negative correlation between CSM,RI,minimum sagittal muscle thickness and CSP disease classification(P<0.05).The AUC of the combined diagnosis of CSM,RI and minimum sagittal muscle thickness for CSP was 0.719%,which was greater than 0.706,0.660and 0.625of the single diagnosis of CSM,RI and minimum sagittal muscle thickness.Conclusion There are obvious abnormalities in CSP by ultrasound.There are significant differences in the parameters of different CSP types,and the two are closely related.Ultrasound can be used to diagnose and evaluate the disease.