杨勇锋　杜　燕　张宁宁　刘　静　李　博西安市北方医院功能科，陕西西安　710043

经会阴超声对前置胎盘的诊断价值

杨勇锋杜燕张宁宁刘静李博
西安市北方医院功能科，陕西西安710043

目的 探讨经会阴超声在前置胎盘的应用价值。方法 收集我院2011年11月～2015年11月产科经腹部诊断为前置胎盘的37例，经会阴检查途径进一步确诊，以产后对实体标本诊断为标准，并对两种检查结果进行分析对照。结果 37例均在我院产科产后得已证实，经腹部8例侧壁前置胎盘被漏诊及误诊，诊断率78.38%。经会阴超声检查2例发生漏诊，诊断率94.59%。结论 经会阴检查显示在前置胎盘其独特的优越性，且方法简便，可重复率，准确率高，容易普及推广，经会阴超声检查对诊断前置胎盘有较高的价值。

经腹超声；经会阴超声；超声诊断；前置胎盘

[Abstract]Objective To discuss diagnostic value of transperineal sonography in placenta previa.Methods A total of 37 patients with transabdominally diagnosed placenta previa treated in our hospital from November 2011 to November 2015 were collected and the patients were confirmed by transperineal examination.Diagnosis of physical specimen was selected as standard.The results of two examination methods were compared.Results The 37 patients were confirmed after delivery.In transabdominal examination,8 cases of lateral placenta previa were missed or misdiagnosed,and the diagnostic rate was 78.38%.In transperineal sonography,2 cases were misdiagnosed,and the diagnostic rate was 94.59%.Conclusion Transperineal sonography has unique advantages in placenta previa,and is easy to conduct and promote with high repeatability and accuracy,showing high value in diagnosis of placenta previa.

[Key words]Transabdominal sonography;Transperineal sonography;Sonographic diagnosis;Placenta previa

前置胎盘是妊娠期常见并发症之一，是导致孕晚期阴道出血的重要原因。前置胎盘发生率较低，在0.3%~0.5%，然而孕妇若不能及时接受彻底有效的治疗，则可导致母婴安全受到严重威胁[1]。临床主要表现为妊娠晚期或临产时发生无诱因、无痛性的反复阴道出血。目前产科诊断前置胎盘的最常见辅助检查是经腹部超声检查。但其对胎盘位于子宫后壁及侧壁的前置胎盘诊断相对困难，有一定的局限性[2]。对于产前经腹部检查疑是为前置胎盘的病例，而后经会阴进一步检查能够准确的检测胎盘的位置，可以提高超声对前置胎盘诊断符合率。有助于临床医师评估，采取相应措施，降低了临床风险性，提高了围产期健康水平。……