本文選題：超聲檢查　切入點：孕早期　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討超聲在孕早期鑒別診斷正常宮內(nèi)妊娠(IUP)與剖宮產(chǎn)瘢痕妊娠(CSP)的應(yīng)用價值。方法:選擇2015年1月至2017年1月在我院就診的222例孕5~10周超聲圖像進行回顧性分析:其中74例CSP作為研究組,同期148例IUP(無剖宮產(chǎn)史宮內(nèi)妊娠(IUP-NCD)74例,剖宮產(chǎn)術(shù)后宮內(nèi)妊娠(IUP-CD)74例)作為對照組。測量子宮矢狀切面妊娠囊(GS)中心或平均中心相對于宮體中垂線的垂直距離及子宮前壁下段較薄處肌層厚度。結(jié)果:1.IUP組和CSP組GS中心或平均中心相對于宮體中垂線的垂直距離比較差異有統(tǒng)計學(xué)意義(P0.05),IUP-NCD組與IUP-CD組比較差異無統(tǒng)計學(xué)意義(P0.05),IUP-NCD組、IUP-CD組分別與CSP組比較差異有統(tǒng)計學(xué)意義(P0.05)。2.GS中心相對于宮體中垂線的垂直距離與GS平均中心相對于宮體中垂線的垂直距離相比較差異無統(tǒng)計學(xué)意義(P0.05)。3.GS中心或平均中心相對于宮體中垂線的垂直距離與手術(shù)病理相比較差異無統(tǒng)計學(xué)意義(P0.05)。4.GS中心或平均中心相對于宮體中垂線的垂直距離在鑒別診斷CSP-內(nèi)生型(CSP-Ⅰ型)與CSP-外生型(CSP-Ⅱ型)上差異無統(tǒng)計學(xué)意義(P0.05)。5.IUP組與CSP組子宮前壁下段較薄處肌層厚度比較差異有統(tǒng)計學(xué)意義(P0.05),IUP-NCD組、IUP-CD組及CSP組兩兩比較差異有統(tǒng)計學(xué)意義(P0.05),CSP-Ⅰ型組與CSP-Ⅱ型組比較差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.應(yīng)用GS中心或平均中心相對于宮體中垂線的垂直距離可以作為一種簡單鑒別孕早期IUP和CSP的超聲檢查方法,但其鑒別CSP-Ⅰ型和CSP-Ⅱ型的價值不大。2.GS中心或平均中心相對于宮體中垂線的垂直距離二者差異無顯著性,應(yīng)用其中一種超聲檢查方法輔助診斷CSP均具有較高的符合率。3.子宮前壁下段較薄處肌層厚度可作為鑒別IUP與CSP的指標(biāo)之一,但其鑒別CSP-Ⅰ型和CSP-Ⅱ型的價值不大。
[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-.

【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.22;R445.1

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