摘要
目的探讨彩色多普勒超声对子宫切口妊娠的诊断价值及对瘢痕厚度剖宫产后再妊娠结局的预测意义。方法选择2017年1—10月子宫切口妊娠75例作为观察组,选择同期有剖宫产手术史正常妊娠者75例作为对照组。观察2组超声影像区别。收集对照组孕24周以上的超声影像资料,根据瘢痕厚度分为Ⅰ级(38例)、Ⅱ级(19例)、Ⅲ级(11例)和Ⅳ级(7例),观察不同分级孕妇妊娠结局。结果观察组宫腔内异常回声率低于对照组,切口肌层厚度薄于对照组,孕囊与切口距离小于对照组,血流指数低于对照组(P <0. 05)。对照组瘢痕厚度不同分级孕妇分娩期缩宫素用量、出血量及产后并发症发生率差异有统计学意义(P <0. 05)。结论超声检查子宫切口妊娠可明确子宫瘢痕的缺陷,可根据瘢痕厚度及时预测子宫破裂、出血和感染的风险。
Objective To investigate value of color Doppler ultrasound in diagnosis of uterine incision pregnancy and predictive significance of cicatrix thickness for re-pregnancy outcome after cesarean section. Methods A total of 75 patients with uterine incision pregnancy during January 2017 and October 2017 were selected as observation group, while other 75 women of normal pregnancy with cesarean section history at the same period were selected as control group. Differences of ultrasound images were observed between two groups. In control group, ultrasonographic informations of over 24 weeks of pregnancy were collected, and the women were divided into grade Ⅰ subgroup （n = 38） , grade Ⅱ subgroup （n = 19）, grade Ⅲ subgroup （n = 11 ） and grade IV subgroup （n = 7） according to scar thickness, and then pregnancy outcomes of subgroups were observed. Results Compared with those in control group, in observation group, abnormal echo rate of uterine cavity was significantly lower, and thickness of ineisional myometrium was more thinner, and distance between gestational sac and incision was shorter, and value of blood flowindex was significantly lower （P 〈 0.05）. There were significant differences in dosages of oxytoein use during delivery period, bleeding volume and incidence rate of postpartum complication among cicatrix thickness subgroups （P 〈 0.05）. Conclusion Uhrasonography for uterine incision pregnancy may identifies defects of uterine scar and predict risks such as uterine rupture, bleeding and in- fection in time.
作者
甄银芝
籍霞
胡晓丽
李萍
王海波
高丽彩
武子先
韩慈
ZHEN Yin-zhi, JI Xia, HU Xiao-li, LI Ping, WANG Hai-bo, GAO Li-cai, WU Zi-xian, HAN Ci(Department of Obstetrics and Gynecology, 260 Hospital of PLA, Shijiazhuang 050000, China)
出处
《解放军医药杂志》
CAS
2018年第10期63-65,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省卫生厅科研基金项目(20171529)
关键词
剖宫产
超声检查
多普勒
彩色
妊娠
异位
瘢痕
Cesarean section
Ultrasonography
doppler
color
Pregnancy
eetopie
Cicatrix
作者简介
[通讯作者]胡晓丽，E-mail：mengzhilu1980@163．com
