超声在孕早期鉴别诊断宫内妊娠和剖宫产瘢痕妊娠的应用研究

发布时间：2018-04-03 05:32

本文选题：超声检查　切入点：孕早期　出处：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨超声在孕早期鉴别诊断正常宫内妊娠(IUP)与剖宫产瘢痕妊娠(CSP)的应用价值。方法:选择2015年1月至2017年1月在我院就诊的222例孕5~10周超声图像进行回顾性分析:其中74例CSP作为研究组,同期148例IUP(无剖宫产史宫内妊娠(IUP-NCD)74例,剖宫产术后宫内妊娠(IUP-CD)74例)作为对照组。测量子宫矢状切面妊娠囊(GS)中心或平均中心相对于宫体中垂线的垂直距离及子宫前壁下段较薄处肌层厚度。结果:1.IUP组和CSP组GS中心或平均中心相对于宫体中垂线的垂直距离比较差异有统计学意义(P0.05),IUP-NCD组与IUP-CD组比较差异无统计学意义(P0.05),IUP-NCD组、IUP-CD组分别与CSP组比较差异有统计学意义(P0.05)。2.GS中心相对于宫体中垂线的垂直距离与GS平均中心相对于宫体中垂线的垂直距离相比较差异无统计学意义(P0.05)。3.GS中心或平均中心相对于宫体中垂线的垂直距离与手术病理相比较差异无统计学意义(P0.05)。4.GS中心或平均中心相对于宫体中垂线的垂直距离在鉴别诊断CSP-内生型(CSP-Ⅰ型)与CSP-外生型(CSP-Ⅱ型)上差异无统计学意义(P0.05)。5.IUP组与CSP组子宫前壁下段较薄处肌层厚度比较差异有统计学意义(P0.05),IUP-NCD组、IUP-CD组及CSP组两两比较差异有统计学意义(P0.05),CSP-Ⅰ型组与CSP-Ⅱ型组比较差异无统计学意义(P0.05)。结论:1.应用GS中心或平均中心相对于宫体中垂线的垂直距离可以作为一种简单鉴别孕早期IUP和CSP的超声检查方法,但其鉴别CSP-Ⅰ型和CSP-Ⅱ型的价值不大。2.GS中心或平均中心相对于宫体中垂线的垂直距离二者差异无显著性,应用其中一种超声检查方法辅助诊断CSP均具有较高的符合率。3.子宫前壁下段较薄处肌层厚度可作为鉴别IUP与CSP的指标之一,但其鉴别CSP-Ⅰ型和CSP-Ⅱ型的价值不大。
[Abstract]:Objective: To investigate the ultrasound in the differential diagnosis of early pregnancy of normal intrauterine pregnancy (IUP) and cesarean scar pregnancy (CSP) application value. Methods: from January 2015 to January 2017 were retrospectively analyzed in our hospital 222 cases of 5~10 weeks pregnant ultrasound image: including 74 cases of CSP as the study group, 148 cases of IUP (no history of cesarean section (IUP-NCD) of 74 cases of intrauterine pregnancy, cesarean section postoperative intrauterine pregnancy (IUP-CD) in 74 cases) as the control group. The measurement of the sagittal section of the gestational sac (GS) center or the average relative to the center of the vertical distance and uterine body midperpendicular anterior muscle thin layer thickness results: 1.IUP group and CSP group GS center or the average vertical distance relative to the center of the palace "and there was a statistically significant difference (P0.05), there was no significant difference between IUP-NCD group and IUP-CD group (P0.05), IUP-NCD group, there was statistically significant difference compared with group CSP group IUP-CD The meaning of (P0.05).2.GS and GS relative to the center of the vertical distance from the mean center of palace body relative to the vertical distance from the palace midperpendicular midperpendicular compared no significant difference (P0.05).3.GS center or the average relative to the center of the vertical distance and pathology of uterine body midperpendicular compared no significant difference (P0.05).4.GS center or the average relative to the center of the palace the vertical distance from the body perpendicular in the differential diagnosis of CSP- type (CSP- type) and CSP- (CSP- II) exogenous no statistically significant difference was statistically significant (P0.05) of.5.IUP group and CSP group, anterior lower segment uterine muscle compared with the thin layer thickness difference (P0.05), IUP-NCD group, there was statistical the significance of IUP-CD group and CSP group 22 (P0.05), the difference was no statistically significant difference between the CSP- group and the CSP- type II Group (P0.05). Conclusion: 1. application of GS center or average relative to the center of the palace body perpendicular to the vertical The distance can be used as a simple method for identification of ultrasound in early pregnancy, IUP and CSP, but the identification of CSP- type I and type II CSP-.2.GS center is of little value or average vertical distance relative to the center of the uterine body midperpendicular two had no significant difference, which applied an ultrasonic inspection method for diagnosis of CSP were high the coincidence rate of.3. under the front wall of the uterus is relatively thin muscle thickness can be used as one of the differential diagnosis of IUP and CSP index, but it is of little value to identify CSP- type I and type II CSP-.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.22;R445.1

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