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目的:观察经阴道彩超定位手术治疗疤痕妊娠的临床效果。方法:对2008年1月~2011年12月收治的剖宫产后瘢痕妊娠患者26例进行经阴道彩超检查,观察妊娠囊或包块与宫颈、膀胱、剖宫产切口位置的关系、测量妊娠囊大小并观察其形态和血流分布情况,并关注子宫峡部的异常回声,在彩超定位下进行手术治疗,观察患者术后第3天、第5天、第4周、第6周经阴道彩超检查瘢痕处的血流指数、血液β-HCG水平及有无并发症发生。结果:经阴道彩超超声显像率为96.15%(25/26),其中妊娠囊型16例、包块型9例、漏诊l例。所有患者均顺利完成手术,无并发症发生,患者血流指数、血液β-HCG水平在术后4~6周均恢复正常。结论:经阴道彩超定位手术治疗瘢痕妊娠具有定位精准、创伤小、并发症少的优点,可保留生育功能,值得临床推广应用。
Objective: To observe the clinical effect of transvaginal ultrasound in the treatment of scar pregnancy. Methods: Twenty-six cases of cesarean scar pregnancy after cesarean section were treated by transvaginal color Doppler ultrasound in January 2008 to December 2011. The relationship between gestational sac or mass and cervical, bladder and cesarean section incision was observed. Pregnancy was measured The size of the capsule and observe its shape and distribution of blood flow, and attention to the abnormal echoes of the isthmus of the uterus, surgery under color Doppler ultrasound positioning, observation of patients after 3 days, 5 days, 4 weeks, 6 weeks after transvaginal ultrasound Check the scar flow index, blood β-HCG levels and the presence of complications. Results: Transvaginal color Doppler ultrasound imaging rate was 96.15% (25/26), of which 16 cases of gestational cysts, mass type in 9 cases, missed diagnosis in 1 case. All patients were successfully completed surgery without complications, the patient’s blood flow index, blood β-HCG levels returned to normal after 4 to 6 weeks. CONCLUSION: Transvaginal ultrasound-guided surgical treatment of scar pregnancy has the advantages of accurate positioning, less trauma and fewer complications, which can retain the function of childbirth and is worthy of clinical application.