超声在剖宫产瘢痕妊娠诊治中的应用

目的 探讨超声在剖宫产瘢痕妊娠诊治中的应用价值.方法 回顾性分析42例剖宫产瘢痕妊娠患者的声像图特征及超声辅助下的治疗方法.结果 42例患者中,超声正确诊断35例(83.3%,35/42).声像图表现:单纯妊娠囊型15例,混合回声型(或包块型)22例,部分位于宫腔型5例.根据患者临床情况及声像图特征,采取子宫动脉栓塞术、超声引导下病灶清除加子宫修补术2例,经腹超声引导下清官术15例,保守治疗20例,综合治疗5例.治疗过程中,超声检查显示病灶逐渐缩小,血流逐渐减少到消失,血β-人绒毛膜促性腺激素逐渐降低到正常.结论 超声检查可以对剖宫产瘢痕妊娠及时、准确地做出诊断;根据患者声像图特征,有助于临床选择恰当的治疗方案,并评估疗效.

Abstract：

Objective To explore the application value of ultrasound in the diagnosis and treatment for cesarean scar pregnancy. Method The ultrasonic features, clinical treatment of 42 cases of cesarean scar pregnancy were reviewed retrospectively. Results Among 42 patients,35 patients (83.3% ,35/42) were diagnosed accurately by ultrasound. The sonographic appearance showed 15 cases were gestational sac-type and 22 cases were mixed mass-type,the other 5 cases were classified into type three in which the gestational sac mostly located at the uterine cavity and only the inferior part implanted in the cesarean scar. Uterine artery embolisation and suction curettage with the sonographic guidance with 2 cases, intra-amniotic administration of MTX under sonographic guidance with 15 cases, expectant treatment with 20 cases or complex treatment with 5 cases. During treatment,ultrasonography showed focus of infection was shrinked gradually and blood flow disappeared, blood (3 -human chorionic gonadotrophin was decreased to normal level. ConclusionUltrasound can diagnose cesarean scar pregnancy promptly and accurately, proportionate treatment would be selected according to the type of cesarean scar pregnancy, and also can evaluate the therapeutic effect.

Application of ultrasound in the diagnosis and treatment for cesarean scar pregnancy

Objective To explore the application value of ultrasound in the diagnosis and treatment for cesarean scar pregnancy. Method The ultrasonic features, clinical treatment of 42 cases of cesarean scar pregnancy were reviewed retrospectively. Results Among 42 patients,35 patients (83.3% ,35/42) were diagnosed accurately by ultrasound. The sonographic appearance showed 15 cases were gestational sac-type and 22 cases were mixed mass-type,the other 5 cases were classified into type three in which the gestational sac mostly located at the uterine cavity and only the inferior part implanted in the cesarean scar. Uterine artery embolisation and suction curettage with the sonographic guidance with 2 cases, intra-amniotic administration of MTX under sonographic guidance with 15 cases, expectant treatment with 20 cases or complex treatment with 5 cases. During treatment,ultrasonography showed focus of infection was shrinked gradually and blood flow disappeared, blood (3 -human chorionic gonadotrophin was decreased to normal level. ConclusionUltrasound can diagnose cesarean scar pregnancy promptly and accurately, proportionate treatment would be selected according to the type of cesarean scar pregnancy, and also can evaluate the therapeutic effect.