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目的探讨经腹和经阴道超声对剖宫产瘢痕妊娠(CSP)超声不同表现分型的诊断效果。方法选取2012年3月至2013年3月在重庆医科大学附属第一医院妇产科超声室诊断为CSP患者38例进行临床追踪,经临床及病理结果确诊CSP35例,将患者的超声声像图按不同表现特点进行分型,分为瘢痕处孕囊部分突入型、瘢痕处孕囊完全突入型和混合团块型,比较经腹和经阴道对各型CSP的诊断准确性。结果 CSP超声分型中瘢痕处孕囊部分突入型经腹和经阴道超声诊断比较差异具有统计学意义(P<0.05),其余2型瘢痕处孕囊完全突入型和混合团块型诊断比较差异无统计学意义。结论瘢痕处孕囊部分突入型诊断最为困难,经阴道超声对其诊断明显优于经腹超声。
Objective To investigate the diagnostic value of different manifestations of cesarean scar pregnancy (CSP) by transabdominal and transvaginal sonography. Methods 38 patients with CSP diagnosed as obstetrics and gynecology department of the First Affiliated Hospital of Chongqing Medical University from March 2012 to March 2013 were selected for clinical follow-up. 35 patients were confirmed by clinical and pathological findings. The ultrasonographic According to the different performance characteristics of the subdivision, divided into part of the gestational sac of the invagination of the scar, pregnancy sac completely mixed type and mixed mass, comparative abdominal and vaginal diagnosis of various types of CSP accuracy. Results There was significant difference in the diagnosis of CSP in the gestational sac scar between the transabdominal and transvaginal ultrasonography (P <0.05), and the difference between the other two types of hypertrophic scar No statistical significance. Conclusion It is most difficult to diagnose some gestational sac in scar by transvaginal sonography. Transvaginal ultrasonography is superior to transabdominal sonography in diagnosing it.