阴道B 超与腹部B 超检查对瘢痕子宫妊娠的诊断比较

目的 探讨阴道B 超与腹部B 超检查对瘢痕子宫妊娠的诊断比较。方法 选择2012 年7 月至2014 年7 月医院收治的瘢痕子宫妊娠患者83 例，对83 例患者采取阴道B 超以及腹部B 超检查，比较2 种检查方式的诊断确诊率、漏诊情况，并观察不同类型瘢痕子宫妊娠患者的超声表现。结果 阴道B 超检查确诊77 例、误诊6 例，确诊率为92.77%，腹部B 超检查确诊66 例、误诊17 例，确诊率为79.52%，2 种检查方式确诊率比较差异有统计学意义（P<0.05）；阴道B 超检查误诊6 例，误诊为黄体破裂出血2 例、炎性包块4 例，腹部B 超检查误诊17 例，误诊为残角子宫妊娠9 例、黄体破裂出血3 例、炎性包块5 例。结论 采用经阴道B 超对于瘢痕子宫的确诊率高于经腹部B 超，在临床工作中，可联合运用经腹部B 超与经阴道B 超检查，对超声图像进行全面、系统的分析，同时应结合血HCG 变化情况进行分析，以提高瘢痕子宫妊娠患者的确诊率以及检出率。

Comparison of the diagnosis of vaginal and abdominal B ultrasound examination in pregnancy uterine scar

Objective To investigate the comparison of vaginal and abdominal B ultrasound examination in the diagnosis of uterine scar pregnancy.Methods From July, 2012 to July, 2014 83 patients with uterine scar pregnancy were conducted with vaginal and abdominal B ultrasound examination. The misdiagnosis rate of two kinds of examination methods were compared to observe the ultrasonographic manifestations of patients with different types of uterine scar pregnancy. Results Off 77 cases diagnosed with vaginal B ultrasound, 6 cases were misdiagnosed, the diagnosis rate was 92.77%, among 66 cases diagnosed with abdominal B ultrasound, 17 cases were misdiagnosed, the diagnosis rate was 79.52. Comparied the two inspection diagnosis rate, the difference was statistically significant (P<0.05). 6 cases were misdiagnosed with vaginal B ultrasound, they were misdiagnosed as corpus luteum rupture in 4 cases and inflammatory mass hemorrhage in 2 cases. 17 cases were misdiagnosed with abdominal B ultrasound examination, of them, 9 cases were misdiagnosed as rudimentary uterine horn pregnancy, 3 cases as corpus luteum rupture hemorrhage, 5 cases as inflammatory mass. Conclusion Using transvaginal B ultrasound for uterine scar has higher rate of diagnosis with abdominal B ultrasound. Transvaginal B ultrasound combined with abdominal B ultrasound examination are performed to analyze the results of ultrasonic image, meanwhile the changes of HCG in the blood are taken into consideration to improve the diagnosis rate of uterine scar pregnancy and the detection rate.