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超声在剖宫产切口瘢痕妊娠诊断及介入治疗中的作用

黄帆1,张蕾1,2,刘丽1,2,吴晶1,2,黄健1,2   

  1. 1. 天津市中心妇产科医院
    2.
  • 收稿日期:2010-11-18 修回日期:2011-03-11 出版日期:2011-09-15 发布日期:2011-09-15
  • 通讯作者: 黄帆

Role of Ultrasonography in the Intervention Therapy of Cesarean Scar Pregnancies

  • Received:2010-11-18 Revised:2011-03-11 Published:2011-09-15 Online:2011-09-15
  • Contact: Huang Fan

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摘要： 摘要 目的：探讨超声在剖宫产切口瘢痕妊娠诊断及介入治疗中的作用。方法：收集2006年1月至2009年12月于本院住院的32例行介入治疗的剖宫产瘢痕妊娠患者的资料，分析其彩色多普勒超声图像特征，并与介入治疗后超声检查及部分术后病理进行对比分析。结果：32例剖宫产瘢痕妊娠中，单纯介入治疗6例，介入治疗+清宫术16例，MTX+介入治疗4例，MTX+介入治疗+清宫术4例，介入治疗+清宫术+全子宫切除术2例。在行介入治疗过程中，利用超声检查显示病灶大小及血流变化，结合血HCG检查，为临床提供治疗依据。结论：彩色多普勒超声检查可为剖宫产切口瘢痕妊娠提供较准确的定位、定性诊断，根据声像图特征分型有助于评估临床治疗方案、患者病程及转归。

关键词: 超声检查, 多普勒, 彩色 , 剖宫产术, 切口瘢痕, 妊娠, 介入治疗

Abstract: Abstract Objective To evaluate the role of ultrasonography in the diagnosis and intervention therapy of cesarean scar pregnancy. Methods Collected records of 32 patients of our hospital with cesarean scar pregnancy diagnosed and managed with intervention therapy.The sample patients were enrolled from Jan.2006 to Dec. 2009.Analyzed Color Doppler sonographic features, ultrasonography after intervention therapy and follow up with pathologic finding. Results Among the 32 patients with cesarean section scar pregnancy , 6 patients were treated with intervention therapy solely, 16 patients with intervention therapy and curettage, 4 patients with intervention therapy and MTX ,4 patients with intervention therapy and MTX and curettage ,2 patients with intervention therapy and MTX and hysterectomy. In the course of the intervention therapy, ultrasound showed the focus size and the blood flow changes, combined with clinical blood HCG examination, provide the technical support for clinical treatment. Conclusions Color Doppler ultrasonography can provide relatively accurate localization and qualitative diagnosis for cesarean section scar pregnancy, Color Doppler Ultrasonography may assist with the assessment of the clinical treatment program course and outcome of patients based on imaging features.

Key words: ultrasonography, Doppler, color, cesarean, scar, pregnancy, intervention therapy