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目的探讨彩色多普勒超声在子宫瘢痕妊娠诊断中的应用价值及影像学特点。方法选取重庆市铜梁区妇幼保健院2016年1月—2017年1月收治的子宫瘢痕妊娠患者30例作为X组,另选取同期正常妊娠孕妇作为Y组。两组孕妇均进行彩色多普勒超声检查,观察两组孕妇血流阻力指数(RI指数)、子宫基层厚度及X组孕妇彩色多普勒超声检查结果:宫腔内有无孕囊、切口处有无包块和回声,子宫肌层厚度是否变薄。结果 X组孕妇RI指数、子宫基层厚度高于Y组(P<0.05)。X组患者中单纯性妊娠囊型15例,子宫肌层内膜厚度为(2.17±0.82)mm,胎囊逐渐向膀胱部位变大,边界逐渐变得不清晰,妊娠组织直径为(47.0±14.3)mm;混合回声包块型12例,子宫肌层内膜厚度为(2.12±0.53)mm,有回声,孕囊周围有丰富的血流,受精卵着床部位在切口处,妊娠组织直径为(48.0±16.1)mm;部分位于宫腔型3例,子宫肌层内膜厚度为(2.21±0.31)mm,妊娠组织直径为(44.0±15.2)mm。结论彩色多普勒超声在子宫瘢痕妊娠诊断中的应用价值较高,可根据影像学特点初步判断患者子宫肌膜厚度、大小及病变部位,利于患者诊治及预后。
Objective To explore the value and imaging features of color Doppler ultrasound in the diagnosis of uterine scar pregnancy. Methods Thirty cases of uterine scar pregnancy admitted to Tongliang District Maternal and Child Health Hospital of Chongqing from January 2016 to January 2017 were selected as group X. Pregnant women of the same period were selected as Y group. Two groups of pregnant women were examined by color Doppler ultrasound to observe the two groups of pregnant women blood flow resistance index (RI index), the thickness of the uterus and the X group of pregnant women color Doppler ultrasound findings: intrauterine gestational sac, incision Whether mass and echo, the thickness of the myometrium thinning. Results The index of RI and the thickness of uterus in X group were higher than those in Y group (P <0.05). In group X, 15 cases of simple gestational cysts were found, the thickness of myometrium was (2.17 ± 0.82) mm, the fetal capsule gradually became larger and the border became unclear. The diameter of the pregnancy tissue was (47.0 ± 14.3) ) mm; mixed echogenic mass in 12 cases, the myometrium intima thickness (2.12 ± 0.53) mm, echo, gestational sac around the rich blood flow, fertilized egg implantation site at the incision, the diameter of the pregnancy tissue (48.0 ± 16.1) mm. Some of them were located in the uterine cavity in 3 cases. The thickness of the myometrium was (2.21 ± 0.31) mm and the diameter of the pregnancy tissue was (44.0 ± 15.2) mm. Conclusion Color Doppler ultrasound in the diagnosis of uterine scar pregnancy is of high value, according to imaging characteristics of the initial determination of uterine myometrial thickness, size and lesion, which is conducive to the diagnosis and treatment of patients with prognosis.