瘢痕妊娠除了做彩超断定 经阴道彩超确诊前期瘢痕妊娠及点评效果临床价值

王珉鑫++++++孙咏梅

[摘要] 意图 探討经阴道彩超确诊前期瘢痕妊娠及点评效果临床价值。 办法 选取2016年1月～2017年1月我院瘢痕妊娠患者50例，均行为阴道超声查看。 成果 50 例术后病理查看确诊包块型29例，孕囊型21例。经阴道超声检出孕囊型18例，包块型30例，未检出2例，契合率为92.0%[（28+18）/50]。经阴道超声查看显现，包块型首要表现为形状多样，质地不均，边界不清，内膜形状异常，回声强弱不均。外周回声强，而中心以弱回声为主，部分患者中心可不见回声。峡部部分增大，与包块分界不明晰，和膀胱间肌层变薄，血流信号以低阻性为主。子宫下段切断有血流丰厚的回声团块呈凌乱散布，回声紊乱。孕囊型首要表现为子宫下段切断有典型孕囊声像，子宫峡部前壁内呈现显着血管搏动或显着的血流痕迹。孕囊外周回声高，中心无回声，部分患者的孕囊较大，宫颈形状正常，且未发现妊娠物。定论 经阴道超声能够精确检测瘢痕妊娠，调查妊娠囊方位、巨细、形状及血流状况，为瘢痕妊娠的确诊和医治供给了牢靠的参阅根据。

[关键词] 经阴道彩超；瘢痕妊娠；包块型；孕囊型

[中图分类号] R445.1；R714.22 [文献标识码] B [文章编号] 1673-9701（2017）31-0098-03

[Abstract] Objective To investigate the diagnosis of early scar pregnancy and efficacy evaluation by transvaginal color ultrasonography. Methods 50 patients with scar pregnancy who were admitted to our hospital from January 2016 to January 2017 were selected， and they were all given transvaginal ultrasonography. Results According to 50 cases of postoperative pathology， 29 cases of massive type and 21 cases of gestational sac were diagnosed. Transvaginal ultrasonography detected 18 cases of gestational sac， 30 cases of massive type， and 2 cases not detected. The coincidence rate was 92.0%[（28+18）/50]. Transvaginal ultrasonography showed that the main manifestations of massive type were various forms， uneven texture， unclear boundaries， endometrial morphology disorders， and uneven echo intensity. The peripheral echo was strong， and the central part was mainly weak echo. There was no echo in some patients in the central part. The isthmus was enlarged locally， with unclear boundaries with the mass， and thinning muscle layer between the bladder. The blood flow signal was dominated by low resistance. In the incision of lower segment of uterus， there was echo mass with rich blood flow， which was distributed in disorder， and the echo was in disorder. The gestational sac type mainly showed typical pregnancy image in the incision of lower segment of uterus. The anterior wall of uterine isthmus showed obvious vascular pulsation or obvious signs of blood flow. The echo of peripheral gestational sac was high， and there was no echo in central part. Some patients were with larger gestational sac， the cervical morphology was normal， and no pregnancy residues were found. Conclusion Transvaginal ultrasonography can accurately detect scar pregnancy. Gestational sac location， size， shape and blood flow conditions are observed， which provides reliable references for the diagnosis and treatment of scar pregnancy.

[Key words] Transvaginal color ultrasonography； Scar pregnancy； Massive type； Gestational sac typeendprint