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目的:探讨经阴道二维及三维超声检查对子宫切口妊娠的临床价值。方法:选择拟诊子宫切口妊娠50例,常规行经阴道二维超声检查,了解子宫及双侧附件情况,观察妊娠组织大小、生长部位、峡部厚度、血供情况,尔后启动三维容积探头,由宫底至宫颈进行图像采集,获得满意的三维超声图像,观察妊娠组织着床部位与子宫切口的关系。结果:(1)本组50例中,孕囊型42例,包块型8例(1例须与滋养细胞肿瘤相鉴别),超声诊断符合率98.0%(49/50);(2)超声引导下行清官术46例,其中子宫动脉栓塞术后超声引导下行清官术15例,腹腔镜下子宫切口妊娠病灶切除术4例。结论:经阴道二维及三维超声检查对子宫切口妊娠临床诊断及治疗具有重要价值。
Objective: To investigate the transvaginal two-dimensional and three-dimensional ultrasound examination of uterine incision pregnancy clinical value. Methods: Fifty cases of gestational uterine incision pregnancy were selected. Vaginal bi-dimensional ultrasound examination was performed routinely to understand the uterus and bilateral appendages. The gestational tissue size, growth site, isthmus thickness and blood supply were observed, and then the three-dimensional volume probe was started. End to the cervix for image acquisition, access to satisfactory three-dimensional ultrasound images, observation of pregnancy tissue implantation site and uterine incision relationship. Results: (1) Among the 50 cases in this group, 42 cases were gestational sac type and 8 cases were mass type (1 case was differentiated from trophoblastic tumor), and the coincidence rate of ultrasonic diagnosis was 98.0% (49/50); (2) Guided the down clean 46 cases, of which uterine artery embolization after ultrasound guided downright surgery in 15 cases, laparoscopic hysterectomy pregnancy resection in 4 cases. Conclusion: Transvaginal two-dimensional and three-dimensional ultrasound examination of uterine incision pregnancy clinical diagnosis and treatment of great value.