超声检测孕晚期子宫前壁下段厚度在预测瘢痕子宫术中破裂风险中的应用价值

发布时间：2017-12-28 09:33

本文关键词：超声检测孕晚期子宫前壁下段厚度在预测瘢痕子宫术中破裂风险中的应用价值　出处：《中国全科医学》2017年15期 　论文类型：期刊论文

【摘要】：目的探讨经腹超声检测孕晚期子宫前壁下段厚度在预测瘢痕子宫再次分娩时术中发生破裂风险的价值。方法 2015年1月—2016年1月选择于丽水市人民医院分娩的瘢痕子宫孕妇150例,再次剖宫产前3 d内,应用经腹超声检测子宫前壁下段厚度。分析术中所见子宫前壁下段破裂情况(分为破裂组和未破裂组)与子宫前壁下段厚度之间的关系。绘制受试者工作特征(ROC)曲线评价子宫前壁下段厚度预测瘢痕子宫术中破裂风险的价值。结果破裂组53例,未破裂组97例。破裂组与非破裂组子宫前壁下段厚度分别为(1.21±0.34)、(2.17±0.53)mm,差异有统计学意义(t=12.009,P0.05)。子宫前壁下段厚度预测瘢痕子宫术中破裂风险的截断值为1.55 mm,其灵敏度为0.903,特异度为0.210,ROC曲线下面积为0.913。结论当子宫前壁下段厚度1.55 mm时提示瘢痕子宫术中发生破裂的风险较高。
[Abstract]:Objective to investigate the value of transabdominal ultrasonography in the measurement of the thickness of the lower segment of the anterior uterine wall in the prediction of the risk of rupture during the recurrence of the uterine cicatricial uterus. Methods from January 2015 to January 2016, 150 cases of scar uterus pregnant women who were delivered in Lishui People's Hospital were selected, and the thickness of anterior inferior wall of uterus was detected by transabdominal ultrasound within 3 d after cesarean section. The relationship between the rupture of the anterior segment of the uterus (divided into rupture group and unruptured group) and the thickness of the inferior segment of the anterior uterine wall was analyzed. To assess the value of the subjects' work feature (ROC) curve to evaluate the thickness of the lower segment of the uterus to predict the risk of rupture in the scar uterus. Results there were 53 cases of rupture group and 97 cases in unruptured group. The thickness of the anterior uterine wall of the rupture group and the non rupture group was (1.21 + 0.34) and (2.17 + 0.53) mm respectively, and the difference was statistically significant (t=12.009, P0.05). The cut-off value of the anterior inferior wall thickness in predicting the rupture risk of scar uterus is 1.55 mm, the sensitivity is 0.903, the specificity is 0.210, and the area under the ROC curve is 0.913. Conclusion when the thickness of the lower anterior segment of the uterus is 1.55 mm, the risk of rupture in the scar uterus is higher.
【作者单位】：浙江省丽水市人民医院超声科;
【分类号】：R445.1;R714.4
【正文快照】： 随着剖宫产率的不断上升以及我国计划生育政策的改变,剖宫产后再次妊娠的患者数也随之增加[1]。瘢痕子宫于再次妊娠晚期及分娩时易发生破裂,是危及母婴生命的严重并发症之一,也是再次剖宫产的主要指征[2]。对瘢痕子宫晚期妊娠患者,临床常要求行超声检测子宫前壁下段厚度以预

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