CAJ | 학술논문

目的探讨超声检查在子宫瘢痕妊娠声像图特征及诊断治疗中的应用价值。方法分析39例子宫瘢痕妊娠声像图特征，并比较保守治疗前后的声像图及血流阻力指数的变化，并参考血β-hCG变化情况评价其治疗效果。结果39例子宫瘢痕妊娠超声显像可分为：①单纯妊囊型21例；②混合回声包块型5例；③部分位于子宫腔型12例，误诊1例（难免流产）。其中16例保守治疗患者，治疗前子宫瘢痕妊娠孕囊周围肌层或团块内部可探及丰富的低阻血流信号；治疗后7d病灶轻度缩小，血流阻力指数无明显变化，与治疗前比较无统计学意义；治疗后28d病灶明显变小，病灶内血流信号明显减少或消失，阻力指数升高，与治疗前比较有统计学意义。结论子宫瘢痕妊娠有特征性声像图表现。超声检查对子宫瘢痕妊娠能做出较准确诊断，对临床制定治疗方案、疗效评估及随访中有重要指导作用。
목적탐토초성검사재자궁반흔임신성상도특정급진단치료중적응용개치。방법분석39례자궁반흔임신성상도특정，병비교보수치료전후적성상도급혈류조력지수적변화，병삼고혈β-hCG변화정황평개기치료효과。결과39례자궁반흔임신초성현상가분위：①단순임낭형21례；②혼합회성포괴형5례；③부분위우자궁강형12례，오진1례（난면유산）。기중16례보수치료환자，치료전자궁반흔임신잉낭주위기층혹단괴내부가탐급봉부적저조혈류신호；치료후7d병조경도축소，혈류조력지수무명현변화，여치료전비교무통계학의의；치료후28d병조명현변소，병조내혈류신호명현감소혹소실，조력지수승고，여치료전비교유통계학의의。결론자궁반흔임신유특정성성상도표현。초성검사대자궁반흔임신능주출교준학진단，대림상제정치료방안、료효평고급수방중유중요지도작용。
Objective To investigate the application value of ultrasonography in sonographic characteristics, diagnosis and treatment of uterine scar pregnancy. Methods The sonographic characteristics of 39 patients of uterine scar pregnancy were analyzed. The changes of blood flow and the resistance index(RI) were compared before and after conservative treatment. Meanwhile, the therapeutic ef ect was evaluated referencing to the changes of in blood. Results The ultrasonoscopy of 39 patients suf ering from uterine scar pregnancy could be divided into three categories:(1) embryo sac(n=21 case);(2) mixed type mass (n=5);(3) part in the uterine cavity(n=12), and 1 misdiagnosed patient (inevitable abortion). Of 16 patients with conservative treatment, Peri-myometrium of the gastrula and the mass had abundant blood flow and lower RI before treatment, 7 days after the treatment of focal mild nar owing, RI has no obvious changes, compared with before treatment had no statistical significance; Within 28 days after treatment were decreased significantly, lesions significantly reduced or disappeared blood flow signal and RI increased, compared with before treatment was statistical y significant. Conclusion Uterine scar pregnancy has characteristics ultrasonogram. Ultrasonography can make more accurate diagnosis for uterine scar pregnancy, which plays an important guiding role in making clinical therapeutic schedule, evaluating curative ef ect and conducting fol ow-up.