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目的:经阴道彩色多普勒超声在子宫瘢痕妊娠(CSP)的早期诊断、治疗中的应用价值。方法:收集2013年2月~2014年11月吉林大学第二医院诊断为CSP患者54例,观察超声图像妊娠囊位置、大小、与子宫切口间关系及血流分布等情况,回顾性分析彩色多普勒超声在CSP的诊断及治疗中的指导意义。结果:根据声像图特征,将CSP分为Ⅰ型(宫内妊娠囊型及瘢痕处浅肌层内妊娠囊型)26例,其中经超声监护下清宫术治愈者23例(88.5%),Ⅱ型(瘢痕处深肌层内妊娠囊型)19例,其中经子宫动脉栓塞术联合清宫术治愈者18例(94.7%),Ⅲ型(混合团块型)5例,其中经腹腔镜下瘢痕妊娠病灶清除术治愈者4例(80.0%)。误诊4例,1例宫颈妊娠,1例稽留流产,2例滋养细胞疾病。结论:经阴道彩色多普勒超声是临床早期诊断CSP的可靠方法,同时对CSP的治疗方案有重要指导作用。
Objective: The value of transvaginal color Doppler ultrasound in the early diagnosis and treatment of uterine scar pregnancy (CSP). Methods: From February 2013 to November 2014, 54 patients diagnosed as CSP in the Second Hospital of Jilin University were enrolled. The location, size of the gestational sac, the relationship with the uterine incision and the distribution of blood flow were observed and analyzed retrospectively. The Significance of Pulsed Ultrasound in the Diagnosis and Treatment of CSP. Results: According to the sonographic features, CSP was divided into type I (gestational sac type in gestational sac type and scarring muscular layer type) in 26 cases, including 23 cases (88.5%) cured by curettage under ultrasound, Nineteen cases were type Ⅱ (gestational sac type with deep myometrial scar), of which 18 cases (94.7%) were cured by uterine artery embolization combined with curettage and 5 cases were type Ⅲ (mixed mass). Among them, Four patients (80.0%) were cured of scar pregnancy removal. Misdiagnosis in 4 cases, 1 case of cervical pregnancy, 1 case of missed abortion, 2 cases of trophoblastic disease. Conclusion: Transvaginal color Doppler ultrasonography is a reliable method for the early diagnosis of CSP, and it also plays an important guiding role in the treatment of CSP.