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目的:探讨剖宫产瘢痕妊娠的超声声像图表现,为临床诊断及治疗提供较为准确的信息。方法:回顾分析近3年来78例剖宫产瘢痕妊娠患者的超声表现,将其归纳分类,分别分析各型患者临床治疗效果。结果:所有患者均在宫腔下段子宫瘢痕部位可见胚囊或包块,根据彩超声像图特征将其分为两类:孕囊型和包块型。结合超声分类结果及临床治疗效果分析,孕囊型患者病灶距子宫浆膜面的肌层厚度(d)≥2 mm时可尝试行直接超声监护下清宫术;超声表现包块型的患者多为剖宫产瘢痕妊娠清宫不全或不全流产后并发症所致,可根据患者具体情况选择经腹腔镜或经腹病灶切除及瘢痕修补手术、长期保守治疗等。结论:经阴道彩超对剖宫产子宫瘢痕妊娠诊断有着重要的价值,严格质控超声检查对临床制定治疗方案具有重要意义。
Objective: To investigate the ultrasound sonography of cesarean scar pregnancy and provide more accurate information for clinical diagnosis and treatment. Methods: A retrospective analysis of 78 cases of cesarean scar pregnancy in the past three years in patients with ultrasound findings, and its classification, respectively, analysis of various types of patients with clinical treatment. Results: All patients showed embryo sac or mass at the uterine scar site of the lower uterine cavity. According to the characteristics of color ultrasonography, they were divided into two groups: gestational sac type and bulky type. Combined with the results of ultrasound classification and analysis of clinical treatment results, gestational sac-type patients with lesions from the uterine serosa surface muscle thickness (d) ≥ 2 mm can try direct ultrasonographic monitoring of curettage; ultrasound showed massive mass of patients Cesarean scar pregnancy due to incomplete or incomplete pregnancy induced complications, according to the specific circumstances of patients by laparoscopic or transabdominal focal resection and scar repair surgery, long-term conservative treatment. Conclusion: Transvaginal ultrasound is important for the diagnosis of uterine scar pregnancy in cesarean section. The strict quality control ultrasound examination is of great significance for clinical treatment planning.