管荟

[摘要] 目的 探讨经阴道彩色多普勒超声检查对瘢痕子宫妊娠的临床诊断价值。方法 方便选择2014年6月—2017年6月期间该院收治的101例瘢痕子宫妊娠患者作为研究对象，其中51例术前选择行经阴道彩色多普勒超声检查作为观察组，50例患者术前选择行经腹彩色多普勒超声检查作为对照组。术后，分别将两组患者彩色多普勒超声诊断结果与病理结果进行对比，对比两组诊断准确率，同时总结分析超声图像特征。结果 观察组彩色多普勒超声诊断准确率（96.08%），显著高于对照组（76.00%），组间差异有统计学意义（P<0.05）。彩色多普勒超声图像可见妊娠囊（不均质团块）着床点及周边相邻肌层可见明显的丰富彩色血流信号，部分可探及滋养细胞血流频谱，脉冲多普勒频谱呈低阻血流（P<0.05）。结论 经阴道彩色多普勒超声诊断瘢痕子宫妊娠的准确性较高，较经腹超声检查漏诊、误诊风险显著降低，且超声图像具有典型特征，可作为首选超声检查方法。

[关键词] 经阴道彩色多普勒超声；瘢痕子宫；妊娠；诊断价值

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0181-03

Value of Transvaginal Color Doppler Ultrasonography in the Diagnosis of Scar Uterus Pregnancy

GUAN Hui

Ultrasound Department， the 457th Hospital of PLA， Wuhan， Hubei Province， 430012 China

[Abstract] Objective This paper tries to investigate the clinical value of transvaginal color Doppler ultrasonography in the diagnosis of scar uterus pregnancy. Methods From June 2014 to June 2017 in this hospital， 101 cases of uterine scar pregnancy patients were convenient selected as the research objects， of which 51 cases underwent transvaginal color Doppler ultrasonography as the observation group， 50 patients underwent transabdominal color Doppler ultrasound examination as the control group. After the operation， two groups of patients were compared with the pathological findings of color Doppler ultrasonography， and the diagnostic accuracy of the two groups was compared. Meanwhile， the characteristics of ultrasonic images were summarized and analyzed. Results The diagnostic accuracy of color Doppler ultrasound in observation group（96.08%） was significantly higher than that in control group（76.00%）， and the difference between groups was significant（P<0.05）. Color Doppler ultrasound image visible gestational sac （not homogeneous mass） implantation site and adjacent muscle layer visible rich color flow signals， some of them and trophoblastic blood flow spectrum， pulse Doppler spectrum was low blood flow resistance（P<0.05）. Conclusion Transvaginal color Doppler ultrasound in the diagnosis of uterine scar pregnancy has higher accuracy than transabdominal ultrasound misdiagnosis， significantly reducing the risk of misdiagnosis， and the ultrasound image has the typical characteristics， can be used as the preferred method of ultrasonic examination.

[Key words] Transvaginal color Doppler ultrasonography； Scar uterus； Pregnancy； Diagnosis value

全面二孩政策落實以来，瘢痕子宫妊娠发病率呈明显上升趋势，成为当前产科较为棘手的问题[1]。瘢痕子宫妊娠是一种高危妊娠，母婴死亡率均较高，早期诊断、及时终止妊娠有助于降低产妇风险[2]。彩色多普勒超声是妇产科常用的检查手段，其广泛应用于早期瘢痕子宫妊娠诊断中，目前临床采用检查方式主要分为经阴道和经腹两种形式，两者在应用限制范围、诊断效果方面存在一定差异性，而近年来临床领域对经阴道彩色多普勒超声诊断效果更为肯定，为进一步探明其诊断价值，该次研究方便选择2014年6月—2017年6月期间该院收治的101例瘢痕子宫妊娠患者作为研究对象，对比分析了经阴道和经腹彩色多普勒超声检查的准确性，并总结了超声图像表现，现报道如下。……