中国药物警戒 ›› 2011, Vol. 8 ›› Issue (10): 587-589.

• 临床研究 • 上一篇    下一篇

彩色超声在子宫疤痕妊娠诊治中的作用

张小英1, 彭艳丽2, 陈涛1, 朱亚利1, 魏金铭1, 王燕1, 贾娟1   

  1. 1 北京市普仁医院超声科,北京 100065;
    2 北京市普仁医院妇科,北京 100065
  • 收稿日期:2011-07-18 出版日期:2011-10-10 发布日期:2015-07-30
  • 作者简介:张小英,女,副主任医师,聚焦超声治疗子宫肌瘤。
  • 基金资助:
    首都医学发展科研基金项目资助（2007-3,编号：11010340080989611A1001007）

The Evaluation of Diagnoses and Management in Cesarean Scar Pregnancy with Color Doppler Ultrasound

ZHANG Xiao-ying1, PENG Yan-li2, CHEN Tao1, ZHU Ya-li1, WEI Jin-ming1, WANG Yan1, JIA Juan1   

  1. 1 Department of Ultrasonography, BeiJing PuRen Hospital, Beijing 100065, China;
    2 Department of Gynecology, BeiJing PuRen Hospital, Beijing 100065,China
  • Received:2011-07-18 Online:2011-10-10 Published:2015-07-30

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摘要： 目的 评价彩色超声在疤痕妊娠诊治中的作用。方法 使用经阴道超声诊断疤痕妊娠病例进行保留生育能力的保守治疗。记录子宫疤痕孕囊时间、超声结果、β-hCG、经阴道彩色超声血流情况和手术方式及经腹超声在术中监测情况。结果 孕囊诊断时间约6周左右,剖腹产时间至疤痕妊娠时间为9~126月。经阴道超声诊断疤痕妊娠如下：孕囊大小0.8cm×0.4cm×0.5cm至2.2cm×2.1cm×1.0cm,有胎心,头臀径0.3cm至0.7cm,前壁肌层厚度0.5cm,血流显像丰富。对患者进行如下处理：子宫动脉栓塞后24小时在超声监测下行宫腔镜吸宫人流术2例,子宫动脉栓塞失败+系统MTX化疗,经阴道超声检查孕囊仍存活,患者自动出院,后随访得知宫腔镜下行吸宫人流术,证实疤痕妊娠1例。结论 经阴道超声是子宫疤痕妊娠早期诊断非常有用手段,在经腹超声术中监测,明显缩短手术时间,减少盲目性,保证了手术安全。

关键词: 疤痕妊娠, 彩色超声

Abstract: Objective To evaluate our experience and diagnosis of cesarean scar pregnancy(CSP) with color doppler ultrasound. Methods From March 2006 to June 2010, 3 cases of cesarean scar pregnancy were diagnosed using color doppler sonography and treated conservatively to preserve fertility. Gastational age, sonographic findings, β-human chorionic gonadotropin(β-hCG) levels, flow profiles of transvaginal color Doppler ultrasound, and trasabdominal sonography during treatment were recorded. Results The gastational sac(GS) ages were diagnosed for about 6 weeks. The time interval from the Cesarean section to the diagnosis of Cesarean scar pregnancy was from 9 months to 126 months. Embryonic period diagnosed by color doppler sonography were as follow: the sizes of GS ranged from 0.8cm×0.4cm×0.5cm to 2.2cm×2.1cm×1.0cm, all with cardiac activity, the crown-rump length ranged from 0.3cm to 0.7cm, the anterior myometrial thickness to the csp were measured 0.5cm with rich color flow show. The patients were treated as follow: ultrasound-guided dilation and curettage under hysteroscopy within 24 hours following uterine artery embolization(n=2), the failure of uterine artery embolization and systemic methotrexate(MTX) injection, the vial GS validated by transvaginal ultrasound, then getting out and dilation and curettage of the csp under hysteroscopy by following-up(n=1). Conclusion Transvaginal ultrasound plays an important and useful role in the early diagnosis of the CSP. During operation under the abdominal ultrasound online screening, it is obvious for the shorteness of opareative time, the decrease of operator's blindness and the safeguard of operative security to dilate and currette.

Key words: Cesarean scar pregnancy, color doppler ultrasound

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