目的：探讨超声在剖宫产瘢痕妊娠诊断与治疗中的应用价值。方法对2011年10月至2013年10月在哈尔滨医科大学附属第一医院经腹部超声检查可疑剖宫产瘢痕妊娠患者行经阴道超声检查患者31例，将超声诊断结果与临床诊断结果对照分析。对临床确诊为剖宫产瘢痕妊娠的患者治疗情况进行记录，将行超声引导下剖宫产瘢痕妊娠病灶清除与未行该治疗患者的治疗效果进行对照分析。结果31例患者中经临床确诊为剖宫产瘢痕妊娠29例，不全流产2例，诊断准确率为93.5％（29／31）。行超声引导下剖宫产瘢痕妊娠病灶清除的患者住院时间为（12.5±1.8） d，较未行该操作的患者（18.8±3.8） d短（P＜0.05），血清β-人绒毛膜促性腺激素降至正常水平所需时间为（23.3±3.3） d，较未行该操作的患者（34.8±4.1） d短（P＜0.05）。结论经阴道超声检查对剖宫产瘢痕妊娠患者有重要的诊断价值，且对治疗方法的选择具有指导作用。经腹部超声引导下剖宫产瘢痕妊娠病灶清除在剖宫产瘢痕妊娠的治疗中具有重要价值。%Objective To assess the application value of ultrasound in the diagnosis and management of Cesarean scar ectopic pregnancy(CSEP).Methods Transvaginal ultrasonography was done on 31 women who were suspected CSEP by transabdominal ultrasonography in the First Hospital Affiliated to Harbin Medi-cal University during Oct.2011 and Oct.2013.The results of ultrasonography diagnosis and clinical diagnosis were compared.The treatment effects of patients who underwent transabdominal ultrasound-guided surgical evacuation of CSEP and those who didn′t were analyzed and compared.Results Among the 31 cases,29 cases were clinically diagnosed as CSEP,and two cases were incomplete abortion.Accuracy of diagnosis was 93.5%(29/31).The length of hospital stay of patients who underwent transvaginal ultrasound-guided surgi-cal evacuation of CSEP was shorter than that of patients who didn′t[(12.5 ±1.8) d vs (18.8 ±3.8) d, P<0.05].The corresponding time for β-human chorionic gonadotropin levels falling to normal were( 23.3 ± 3.3 ) d vs (34.8 ±4.1) d(P<0.05).Conclusion Transvaginal ultrasonography plays an important role in the diagnosis and the choices of therapeutic method of CSEP.Transabdominal ultrasound-guided surgical evacuation of CSEP plays an important part in the management of CSEP.
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