超声在剖宫产瘢痕子宫妊娠中的诊断价值

目的观察超声在瘢痕子宫妊娠诊断中的临床价值。方法32例瘢痕子宫妊娠患者采用多普勒超声诊断仪诊断。观察子宫、双侧附件和孕囊着床的超声表现，观察病灶及孕囊周围血流，测量孕囊与子宫浆膜层的距离，分析多普勒频谱，记录并比较治疗前、治疗1周后和治疗1个月后的阻力指数（RI）和β-hCG值。结果治疗1个月后，27例患者子宫恢复正常，病灶及周围血流消失；4例由于妊娠时间长，宫腔内回声清晰，但未检查到明显血流信号；1例探及明显血流信号且回声不均匀，治疗1．5个月后，复查无血流信号且回声均匀。治疗1个月后砒高于治疗前，差异有统计学意义（P〈0．05）。结论超声对瘢痕妊娠有准确定位作用，在对病情评估、治疗方案制定中有重要的指导作用。

Diagnosis value of ultrasound in cesarean scar pregnancy

Objective To observe the diagnosis value of ultrasound in cesarean sear pregnancy. Methods 32 cases patients with cesarean scar pregnancy diagnosised by doppler ultrasound. Observe the sonographic appearance of hysterectomy, bilateral annex,gestational sac implantation conditions. Observed the blood flow around the lesion and gestational sac,measured the distance between gestational sac and uterine serosa,analysised the doppler and recorded. Compared the RI and b-hCG a mong pretreatment, 1 week after treatment and 1 month after treatment. Results 1 month after treatment,27 cases patients＇ u teras return to normal,blood flow around the lesion disappeared. 4 patients with gestation length for a long time,the echo of u terine cavity was clear,and no flow signal. 1 patient with apparent flow signal,and echo uneven,1.5 months after treatment,no flow signal and the echo uniform. The level of RI after 1 month treatment was higher than that before treatment, the difference was statistically significant（P 〈 0.05）. Conclusion Ultrasound can accurately locate the scar pregnancy, has directive func tion in condition assessment and treatment program development.