超声在剖宫产瘢痕妊娠诊断及治疗中的应用价值

目的探讨经腹及经阴道联合超声对剖宫产瘢痕妊娠(caesarean scar pregnancy,CSP)诊断的临床价值,以及CSP的超声分型对临床个性化治疗CSP的指导价值。方法回顾分析河南科技大学第一附属医院超声诊断28例CSP住院患者声像图特征,及其保守治疗、手术治疗和病理结果及患者转归情况。结果 28例均获得明确诊断,将CSP分四型,孕囊型6例,结节型9例,团块型8例,巨块型5例;3例孕囊型为超声及临床确诊,25例均获得病理标本,其中24例显微镜下可见绒毛组织,1例病理确诊为绒癌,诊断正确率为96.4%。结论超声早期诊断CSP具有重要价值,而且对CSP的个性化治疗具有重要指导价值。

Application value of ultrasonography in the diagnosis and treatment of cesarean scar pregnancy

Objective To investigate the clinical value of sonography in the diagnosis of cesarean scar pregnancy（CSP）and ultrasonographic importance for guiding the individual treatment of CSP . Methods The clinical data of 28 cases of CSP were retrospectively analyzed including CSP ultrasonic characteristics,individual clinical treatment methods,pathologic results and recovery outcomes. Results The ultrasonograms of 28 cases of CSP were characterized as four types：sac type（6 cases）,node type（9 cases）,mass type（8 cases）,large mass type（5 cases）. 3 cases of sac type were ultrasonic and clinical confirmed,25 cases were confirmed by pathological diagnosis,in which chorion of 24 cases were detected by microscope,1 case was choriocarcinoma confirmed by pathological diagnosis,the diagnostic accuracy rate is 96. 4% . Conclusion Ultrasonography can provide important evidence for early diagnosis of CSP,which plays a key role in guiding the individual treatment of CSP.