本文關(guān)鍵詞： 超聲檢查 產(chǎn)前 前置胎盤 胎盤 侵入性　出處：《中華醫(yī)學(xué)超聲雜志(電子版)》2016年03期 　論文類型：期刊論文

【摘要】：目的總結(jié)兇險(xiǎn)型前置胎盤(PPP)合并胎盤植入產(chǎn)前超聲聲像圖特征,分析PPP合并胎盤植入產(chǎn)前超聲漏誤診原因。方法應(yīng)用經(jīng)腹部聯(lián)合經(jīng)會(huì)陰部彩色多普勒超聲對(duì)臨床擬診為PPP的51例孕婦行系統(tǒng)超聲檢查,與產(chǎn)后手術(shù)病理及臨床隨訪結(jié)果對(duì)照分析。結(jié)果 51例PPP患者產(chǎn)前超聲診斷完全性前置胎盤39例,不完全性前置胎盤12例,其中合并胎盤植入40例(78.4%,40/51),未合并胎盤植入7例(13.7%,7/51)。產(chǎn)后臨床及手術(shù)病理檢查證實(shí)51例PPP患者合并胎盤植入42例(82.4%,42/51),未合并胎盤植入9例(17.6%,9/51);因超聲圖像不典型產(chǎn)前超聲漏診2例(3.9%,2/51),誤診2例(3.9%,2/51,將膀胱靜脈曲張誤認(rèn)為血管橫跨胎盤與膀胱間)。51例PPP患者經(jīng)腹部超聲檢查顯示胎盤增厚、彌漫性或局灶性胎盤實(shí)質(zhì)內(nèi)腔隙血流25例,胎盤后間隙消失、胎盤附著處子宮肌層變薄(≤2 mm)44例,子宮肌層弓狀動(dòng)脈排列紊亂34例,胎盤附著處子宮漿膜層-膀胱交界處血管豐富紊亂18例;經(jīng)會(huì)陰部超聲顯示子宮下段膨隆、胎盤增厚25例,宮頸膨大、胎盤局部向?qū)m頸內(nèi)伸入6例,子宮下段及宮頸管胎盤覆蓋處血流豐富8例。結(jié)論孕婦兇險(xiǎn)型前置胎盤有特征性超聲表現(xiàn),經(jīng)腹部聯(lián)合經(jīng)會(huì)陰超聲檢查有助于正確診斷而減少誤漏診。
[Abstract]:Objective to summarize the placenta previa (PPP) complicated with placenta accreta antenatal sonographic features, analysis of PPP complicated with placenta accreta antenatal ultrasound misdiagnosis. Methods abdominal joint perineal color Doppler ultrasound diagnosed 51 cases of pregnant women for PPP ultrasound, and clinical follow-up results were analyzed after operation the pathological results of 51 cases of PPP patients. The prenatal ultrasound diagnosis of complete placenta previa in 39 cases, 12 cases of incomplete placenta previa, 40 cases with placenta implantation (78.4%, 40/51), with 7 cases of placenta accreta (13.7%, 7/51). After clinical and pathological examination confirmed 51 cases of 42 PPP patients with placenta implant (82.4%, 42/51), with 9 cases of placenta accreta (17.6%, 9/51); because of atypical ultrasonic images of prenatal ultrasound misdiagnosis of 2 cases (3.9%, 2/51), 2 cases were misdiagnosed (3.9%, 2/51, bladder varices mistaken across the placenta and vascular bladder Cystine) between placenta thickening by abdominal ultrasound examination showed that.51 patients with PPP, diffuse or focal placental parenchyma cavity gap in 25 patients, disappeared after placental clearance, placenta myometrial thinning (less than 2 mm) in 44 cases, uterine arcuate artery disorder in 34 cases, at the uterine serosa bladder junction vascular disorders and 18 cases of placenta attached; perineal ultrasound showed lower uterine segment swelling, 25 cases of cervical enlargement, placenta thickening, placenta to cervical extend in 6 cases, lower uterine segment and cervical placenta covered rich blood flow in 8 cases. Conclusion: pregnant women with placenta previa features ultrasound, abdominal sonography is helpful to the correct diagnosis and reduce misdiagnosis.

【作者單位】： 南京醫(yī)科大學(xué)附屬蘇州醫(yī)院
【分類號(hào)】：R445.1;R714.56

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