剖宫产疤痕处妊娠超声诊断及解决方案探讨

摘要

Objective To discuss the value of ultrasonic diagnosis in caesarean scar pregnancy,and to evaluate the value of the image features in providing reference for clinical solutions.Methods Ultrasound was used to diagnose and classify cesarean scar pregnancy.According to the relationship between lesions and uterine cavity,muscular layer,and the protruding levels of serous and blood supply situation,different clinical solutions were taken.Results Thirty cases of caesarean scar pregnancy were diagnosed,including 10 cases of simple gestational sac (type Ⅰ),6 cases of mixed mass (typeⅡ),and 14 cases with gestational sac in uterine cavity (typeⅢ).Among the 30 cases,14 received medical abortion combined with local drug administration,laparoscopic abortion,scar repair,and 3 received transvaginal cesarean scar pregnancy debridement surgery combined with scar repair,with 10 cases undergoing medical abortion com-bined with debridement surgery under ultrasound monitoring and 3 cases continuing pregnancy.Conclusion Ultra-sound can diagnose cesarean scar pregnancy early,and provide a valuable reference for clinical solutions.%目的 探讨超声诊断剖宫产疤痕处妊娠,并根据其图像特征为临床提供参考解决方案的价值.方法 运用超声对剖宫产疤痕处妊娠诊断并分型,依据病灶与宫腔、肌层的关系,以及突出浆膜程度和血供情况,采取不同的临床解决方案.结果 超声诊断疤痕处妊娠30例,其中单纯妊娠囊型(Ⅰ型) 10例,混合包块型(Ⅱ型) 6例,孕囊部分位于宫腔型(Ⅲ型) 14例.30例疤痕处妊娠孕妇中药流+局部用药+腹腔镜妊娠物清除+疤痕修补术14例,阴式疤痕妊娠物清除+疤痕修补术3例,药流+超声监测下清宫10例,继续妊娠3例.继续妊娠孕妇除伴有前置胎盘及轻度胎盘植入外,均无不良结局发生.结论 超声能早期明确诊断剖宫产疤痕处妊娠,并可为临床提供较有价值的参考解决方案.