梁理娟?刘碧玉?赖华强

[摘要] 目的 探讨经阴道彩色多普勒超声对子宫剖宫产术后瘢痕妊娠的诊断价值。 方法 对临床证实的25例子宫剖宫产术后瘢痕妊娠患者的经阴道彩色多普勒超声声像图进行回顾性分析。 结果 25例子宫剖宫产术后瘢痕妊娠经阴道彩色多普勒超声正确诊断22例，诊断符合率88%。妊娠囊型17例，包块型5例。误诊为宫颈妊娠2例，误诊为滋养细胞肿瘤1例。 结论 子宫剖宫产术后瘢痕妊娠的经阴道彩色多普勒超声声像图具有一定的特征性，结合临床能够提高正确的诊断率并指导临床治疗。

[关键词] 妊娠；瘢痕；子宫；剖宫产术；超声检查

[中图分类号] R714.22 [文献标识码] A [文章编号] 2095-0616（2017）10-72-04

Diagnostic value of transvaginal color Doppler ultrasound for cesarean scar pregnancy

LIANG Lijuan LIU Biyu LAI Huaqiang

Department of Ultrasound， the Second People's Hospital of Zhaoqing， Guangdong， Zhaoqing 526060， China

[Abstract] Objective To evaluate the diagnostic value of transvaginal color Doppler ultrasonography for cesarean scar pregnancy. Methods Transvaginal color Doppler ultrasonography in 25 cases of scar pregnancy after cesarean section were analyzed retrospectively. Results Among the 25 cases of scar pregnancy after cesarean section by transvaginal color Doppler ultrasound， there were 22 cases with correct diagnosis， the diagnostic accuracy rate was 88%. There were 17 cases with gestational sac type， and the inclusion type in 5 cases. There were 2 cases misdiagnosed as cervical pregnancy， 1 cases misdiagnosed as trophoblastic tumor. Conclusion Transvaginal color Doppler sonography of uterine scar pregnancy after cesarean section has characteristics， combined with clinical. It can improve the correct diagnosis rate and guide clinical treatment.

[Key words] Pregnancy； Cicatrix； Uterus； Cesarean section； Ultrasonography

子宫剖宫产术后瘢痕妊娠（cesarean scars pregnancy，CSP），是一种特殊类型的异位妊娠，是指剖宫产术后瘢痕部位妊娠，受精卵、滋养叶细胞种植于前次剖宫产切口瘢痕处。由于现在国内实行剖宫产术后的人数明显增多致使子宫剖宫产术后瘢痕妊娠发病率呈明显上升趋势[1-3]。CSP如漏诊、误诊或治疗不当可致大出血及子宫破裂等严重后果，危及患者生命[4-6]。影像学检查对CSP诊断具有重要价值，本文旨在分析总结子宫剖宫产瘢痕妊娠经阴道彩色多普勒超声的表现及指导临床治疗中的价值。

1 资料与方法

1.1 一般资料

本文搜集我院自2015年3月～2016年12月间临床、影像学资料完整，经手术和病理证实为子宫剖宫产术后瘢痕妊娠的门诊及住院患者共计25例。年龄25～40岁，平均年龄（32.1±0.8）岁，所选患者均有剖宫产1～2次病史，其中剖宫产1次有19例，2次有6例。……