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目的分析剖宫产瘢痕妊娠的超声声像图特征为其诊断提供依据。方法回顾性分析经阴道彩色多普勒超声诊断为剖宫产瘢痕妊娠患者21例的临床资料,观察包块位置及其与子宫切口关系,子宫下段切口处肌层厚度及血流情况。结果 21例剖宫产术后瘢痕妊娠孕妇经阴道超声分为单纯孕囊型、不均质包块型、孕囊部分位于宫颈管或宫腔型。彩色多普勒声像图有不同表现,包块内及其周边可见少许点状或丰富血流信号,部分病灶可见五彩状血流征象。治疗方案的选择与患者β-h CG值、孕囊或包块的类型、子宫下段切口处肌层厚度及血流情况有关。结论经阴道彩色多普勒超声检查对剖宫产瘢痕妊娠诊断有重要临床应用价值,掌握剖宫产瘢痕妊娠声像图特征对剖宫产瘢痕妊娠诊治提供了依据。
Objective To analyze the echographic features of cesarean scar pregnancy for its diagnosis. Methods The clinical data of 21 cases with cesarean scar pregnancy diagnosed by transvaginal color Doppler ultrasonography were retrospectively analyzed. The location of the mass and the relationship with the uterine incision were observed. The thickness and blood flow of the myometrium at the lower uterine incision were observed. Results 21 cases of cesarean scar pregnancy after transvaginal ultrasound were divided into simple gestational sac type, heterogeneous mass type, part of the gestational sac located in the cervical canal or uterine type. Color Doppler sonography has different manifestations, within the mass and its periphery can see a little punctate or rich blood flow signals, some lesions visible multicolored blood flow signs. The choice of treatment is related to the patient’s β-h CG value, the type of gestage sac or mass, the thickness of the myometrium at the lower uterine incision, and blood flow. Conclusion Transvaginal color Doppler ultrasound examination of cesarean scar pregnancy has important clinical value, pregnancy cesarean scar pregnancy to grasp the characteristics of the sonography of cesarean scar pregnancy provide a basis for diagnosis and treatment.