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目的探讨经腹部彩色多普勒超声(TACD)与经阴道彩色多普勒超声(TVCD)联合诊断剖宫产后瘢痕妊娠患者的影像特点及诊断治疗意义。方法将该院2015年2月-2017年1月期间治疗的58例剖宫产后瘢痕妊娠患者作为研究对象,按照随机原则将其分为观察组(27例)和对照组(31例)。对照组患者给予单纯的TACD诊断,而观察组患者给予TACD与TVCD联合诊断,回顾分析两组患者的超声影像特征及治疗过程,比较分析两组患者的超声指标、血β-h CG值、肌层厚度、RI及诊断准确率和临床治疗效果。结果观察组患者治疗后的血β-h CG水平、肌层厚度、RI及超声指标均显著低于对照组,两组比较差异有统计学意义(P<0.05)。58例研究对象中,经TACD确诊40例,误诊9例,漏诊9例,诊断正确率为68.9%;而TACD与TVCD联合诊断确诊52例,误诊6例,无漏诊患者,诊断正确率为89.7%。CSP超声图像大致可分为3种类型,具体包括单纯妊娠囊型、混合回声包块型及部分位于宫腔型。图像显示,妊娠囊或不均质团块周边均有血流,且较为丰富。结论 TACD与TVCD联合诊断在剖宫产后瘢痕妊娠治疗中的效果显著,且诊断结果可靠、操作简便安全,对妊娠囊与肌层的分级关系及血供关系清晰明了,为治疗方案的选择提供了准确的声像学依据,提高了临床疗效。
Objective To investigate the imaging features and diagnosis of cesarean scar pregnancy after transcapsular color Doppler ultrasonography (TACD) and transvaginal color Doppler ultrasound (TVCD). Methods Fifty-eight patients with cesarean scar pregnancy treated during the period from February 2015 to January 2017 were randomly divided into two groups: observation group (27 cases) and control group (31 cases). Control group were treated with pure TACD diagnosis, the observation group were administered with TVCD TACD combined diagnosis, ultrasound imaging features retrospective analysis of patient groups and treatment, ultrasound indicators Comparison of two groups of patients, serum β-h CG value, muscle Layer thickness, RI and diagnostic accuracy and clinical effect. Results The levels of β-h CG, muscular layer thickness, RI and ultrasound in observation group were significantly lower than those in control group after treatment. There was significant difference between the two groups (P <0.05). Of the 58 subjects, TACD was diagnosed in 40 cases, misdiagnosed in 9 cases and missed in 9 cases, the diagnostic accuracy rate was 68.9%. TACD and TVCD combined diagnosis of 52 cases, misdiagnosed 6 cases, no missed diagnosis, the correct diagnosis rate was 89.7 %. CSP ultrasound images can be roughly divided into three types, including pure gestational sac type, mixed echo mass type and part of the uterine cavity type. Images show that gestational sac or heterogeneous mass around the blood flow, and more abundant. Conclusion TACD and effect TVCD diagnosing pregnancy after cesarean section scar treatment significantly, and reliable diagnosis, easy to operate safe blood supply to the hierarchical relationship and the relationship between gestational sac with muscular layer of clarity, to provide treatment options The basis of accurate acoustic imaging, improve the clinical efficacy.