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目的探讨二维超声和三维超声容积测量(VOCAL)技术在剖宫产后瘢痕憩室妊娠诊治中的应用效果,为剖宫产后瘢痕憩室妊娠诊治方案的选择提供依据。方法回顾性分析2015年6月至2016年11月拟于我院行手术治疗的剖宫产后瘢痕憩室疑似憩室妊娠者42例为研究对象,均先行二维超声检查,然后行VOCAL技术检查,观察疤痕憩室的形态和回声特点,确定瘢痕憩室妊娠发生情况。患者均行手术治疗,以术后病理检查诊断结果为金标准,分析二维超声和VOCAL技术在剖宫产后瘢痕憩室妊娠诊断中的应用价值。结果 VOCAL技术确诊瘢痕憩室妊娠发生率为90.48%,二维超声确诊瘢痕憩室妊娠发生率为73.81%,术后病理检查确诊瘢痕憩室妊娠发生率为85.71%。诊断试验四格表分析结果显示二维超声诊断剖宫产后瘢痕憩室妊娠的敏感度、特异度和准确性分别为80.56%、66.67%和78.57%,VOCAL技术诊断剖宫产后瘢痕憩室妊娠的敏感度、特异度和准确性分别为97.22%、50.00%和90.48%,VOCAL技术诊断瘢痕憩室妊娠价值优于二维超声。结论 VOCAL技术在剖宫产后瘢痕憩室妊娠诊治中的应用价值均优于二维超声,理论上其对剖宫产后瘢痕憩室妊娠治疗的指导效果更佳,应首选VOCAL技术进行剖宫产后瘢痕憩室妊娠诊断和临床治疗。
Objective To investigate the effect of two-dimensional ultrasound and three-dimensional volume measurement (VOCAL) technique in the diagnosis and treatment of scar diverticulum after cesarean section, and provide evidence for the selection of the diagnosis and treatment of scar diverticulum after cesarean section. Methods Retrospective analysis from June 2015 to November 2016 in our hospital surgical treatment of cesarean section scar diverticulum suspected diverticulum pregnancy in 42 cases as the object of study, are first two-dimensional ultrasound, and then perform VOCAL examination, Observe the morphological and echogenic characteristics of scar diverticulum to determine the occurrence of scar diverticulum pregnancy. The patients underwent surgical treatment. The diagnostic value of postoperative pathological examination was the gold standard. The value of two-dimensional ultrasound and VOCAL in the diagnosis of scar pregnancy after cesarean section was analyzed. Results The pregnancy rate of scar diverticulum diagnosed by VOCAL technique was 90.48%. The incidence of pregnancy induced by two - dimensional ultrasonography in scar diverticulum was 73.81%. The incidence of scar diverticulum pregnancy confirmed by postoperative pathology was 85.71%. The results of the four-table analysis of diagnostic tests showed that the sensitivity, specificity and accuracy of two-dimensional ultrasound in the diagnosis of post-cystectal scar diverticulum pregnancy were 80.56%, 66.67% and 78.57% respectively. VOCAL was used to diagnose scar diverticulum pregnancy after cesarean section Sensitivity, specificity and accuracy were 97.22%, 50.00% and 90.48%, respectively. VOCAL was superior to 2DE in the diagnosis of scar diverticula. Conclusion VOCAL technique is superior to two-dimensional ultrasound in diagnosis and treatment of scar diverticulum after cesarean section. In theory, VOCAL technique has a better guiding effect on post-cesarean scar scar diverticulum pregnancy. VOCAL technique should be the first choice after cesarean section Diagnosis and clinical treatment of scar diverticulum pregnancy.