单华英，费敬英，刘明松

(湖州市妇幼保健院，浙江 湖州 313000)

·基础与临床研究·

胎盘早剥超声表现与临床病理结果对比分析

单华英，费敬英，刘明松

(湖州市妇幼保健院，浙江 湖州 313000)

目的：通过分析被临床病理证实为胎盘早剥的超声声像图特点，提高对胎盘早剥的认识。方法回顾性分析63例胎盘早剥的声像图表现并与病理诊断结果比较。结果超声提示胎盘早剥55例，不能做出诊断提示的7例，误诊1例。超声诊断胎盘早剥符合率为87.30%(55例), 其中前壁胎盘及重度胎盘早剥符合率高, 而后壁胎盘及轻度早剥符合率低。声像图特征：胎盘后血肿29例,胎盘边缘血肿10例，胎盘局部增厚9例,绒毛膜下血肿7例。结论超声诊断胎盘早剥符合率较高，但同时超声本身也存在局限性，应结合临床症状，改变体位多切面扫查，对可疑区使用彩色多普勒血流显像(CDFI)，必要时动态复查，有助于提高诊断符合率。

超声；胎盘早剥；彩色多普勒血流显像(CDFI)

Abstract：[Objective] To improve the diagnosis of placental abruption by analyzing the sonographic characteristics of placental abruption cases that had been detected by clinical pathology. [Method] A retrospective analysis was conducted on the ultrasonic images for 63 placental abruption cases. [Result] Among 63 placental abruption cases, ultrasound diagnosed 55 cases, misdiagnosed 2 cases and failed to diagnose 6 cases. The coincidence rate of ultrasound diagnosis of placenta abruption was 87.3% (55 cases). There were more cases with anterior placental and severe abruption than posterior placenta and mild abruption without symptoms. The sono-graphic characteristics of placental abruption detected 29 cases of retroplacental hematoma, 10 cases of marginal placenta hematoma, 9 cases of partial thickened placenta and 7 cases of subchorionic hematoma. [Conclusion] The coincidence rate of ultrasound diagnosis of placental abruption is high, but at the same time, ultrasound has limitations. To improve the diagnosis rate of placental abruption, ultrasound should be combined with clinical symptoms, multi-section scanning by changing the position, the use of color Doppler flow imaging (CDFI) in suspected area, and dynamic check when necessary.

Keywords: ultrasound; placental abruption; color doppler flow imaging (CDFI)

妊娠20周后或分娩期，正常位置的胎盘在胎儿娩出前，部分或全部从子宫壁剥离，称为胎盘早剥。胎盘早剥发生率约1:47～1:217[1],是妊娠中晚期严重并发症，起病急、发展快，若不及时处理，可危及母儿生命。近年超声检查已广泛用于胎盘早剥的诊断和评估[2]。本文回顾性分析我院2008年至2014年产前经超声检查、产后临床病理证实为胎盘早剥的63例超声特征，以提高对胎盘早剥的认知和产前诊断的准确率。

1 资料与方法

1.1 一般资料

收集我院2008年11月至2014年11月63例经临床病理证实为胎盘早剥的患者, 均产前经过超声检查。……