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目的探讨经阴道超声在剖宫产切口瘢痕早期妊娠诊断中的应用。方法选择2012年1月—2013年12月收治的经阴道超声诊断为剖宫产瘢痕妊娠患者20例,回顾分析其临床资料,总结其超声图像特征。结果 20例经阴道超声检查疑似剖宫产切口瘢痕妊娠患者术后病理确诊为18例,诊断准确性为90.00%;8例单纯孕囊型均有子宫增大表现,子宫下段切口处能看见妊娠囊呈“双环征”。10例不均质团块型子宫下段剖宫产切口处出现杂乱回声,内部能见片状无回声区,同时团块与肌层没有明显分界,回声呈紊乱状态;4例患者探及高速低阻频谱(RI<0.05)的丰富血流信号,8例探及少许血流信号,6例未探及血流信号。结论经阴道超声能有效、快速、准确诊断剖宫产切口瘢痕妊娠,为临床选择合理治疗方案提供依据,值得推广应用。
Objective To investigate the application of transvaginal ultrasound in early pregnancy diagnosis of cesarean scar incision. Methods Twenty patients with cesarean scar pregnancy were diagnosed by transvaginal sonography from January 2012 to December 2013. The clinical data were retrospectively analyzed and the features of ultrasound images were summarized. Results Twenty cases of suspected cesarean scar pregnancy were diagnosed by transvaginal ultrasonography in 18 cases and the diagnostic accuracy was 90.00%. All 8 cases of simple gestational sac showed enlarged uterus, and the lower uterine incision could see the pregnancy Sac was “double ring sign.” 10 cases of heterogeneous mass uterine segment of the uterine segment of the cesarean section appeared at the echogenic incision, the internal can see sheet anechoic area, while the clumps and muscular layer no obvious boundaries, the echo was in a chaotic state; 4 cases of exploration and high-speed low (RI <0.05) rich blood flow signal, 8 cases of exploration and a little blood flow signal, 6 cases did not explore and blood flow signal. Conclusion Transvaginal ultrasonography can effectively, quickly and accurately diagnose cesarean scar pregnancy and provide a basis for clinical choice of rational treatment, which is worth popularizing and applying.