摘要
目的探讨准确、安全、方便地诊断前置胎盘的超声检查方法。方法回顾性分析2012年1月-2014年12月在本院住院并经剖宫产术后证实的前置胎盘的97例孕妇超声和临床病例资料,比较单纯经腹超声、经腹与经会阴超声联合应用诊断前置胎盘的临床价值,将前置胎盘分为前壁型、后壁型及侧后壁型,与剖宫产术后结果进行对照。结果 97例前置胎盘均经临床术后证实,经腹超声诊断76例,漏诊14例,误诊7例,其诊断符合率为78.35%,采用经腹联合经会阴超声后,其中的18例得到纠正,漏诊3例,即诊断符合率提高到96.91%（94/97）,两种方法比较差异有统计学意义（χ^2=15.406,P〈0.05）。97例前置胎盘,其中前壁型前置胎盘44例,经腹超声检查诊断42例,诊断符合率为95.45%,经腹联合会阴超声检查诊断44例,诊断符合率为100.00%,两种方法比较差异无统计学意义（χ^2=2.046,P〉0.05）。剖宫产术后证实的后壁和侧后壁型前置胎盘53例,经腹超声检查诊断38例,诊断符合率为71.70%,经腹联合经会阴超声检查诊断后壁型和侧后壁型前置胎盘50例,诊断符合率为94.34%,经腹联合经会阴超声检查明显优于单纯经腹超声检查（χ^2=9.636,P〈0.05）。结论经腹与经会阴超声联合应用能明显提高对前置胎盘的诊断符合率,且方法安全简便,具有较高的临床应用价值,值得推广应用。
Objective To explore an accurate,safe,and convenient ultrasonic inspection method in diagnosis of placenta previa. Methods Ultrasound and clinical data in 97 pregnant women confirmed placenta previa by caesarean section in our hospital from January 2012 to December 2014 was retrospectively analyzed to compare the clinical value of simple transabdominal ultrasound and transabdominal combined with transperineal ultrasound in diagnosis of placenta previa.Placenta previa was classified into three types:the anterior wall type,the posterior wall type,and the lateral posterior wall type,and its result was compared with the result after caesarean section. Results 97 cases with placenta previa were confirmed after clinical operation,76 cases were diagnosed by transabdominal ultrasound as placenta previa,14 cases were undiagnosed,and 7 cases were misdiagnosed.The diagnose accordance rate of transabdominal ultrasound was78.35%.After combined with transperineal ultrasound,18 cases were corrected,and 3 cases were still undiagnosed.The diagnose accordance rate was enhanced to 96.91%(94/97).The difference between two methods showed statistical significance(χ~2=15.406,P<0.05).In 97 cases with placenta previa,44 cases were anterior wall type,of which 42 cases were diagnosed by transabdominal ultrasound,and its diagnose accordance rate was 95.45% and 44 cases were diagnosed by combined transabdominal and transperineal ultrasound,and its diagnose accordance rate was 100.00%,and the difference between two methods showed no statistical significance(χ~2=2.046,P >0.05).53 cases were confirmed as posterior wall type and lateral posterior wall type by caesarean section,of which 38 cases were diagnosed by transabdominal ultrasound,and its diagnose accordance rate was 71.70%,while 50 cases were diagnosed by combined transabdominal and transperineal ultrasound,and its diagnose accordance rate was 94.34%,and it showed that the combined application was significantly superior to the simple use of transabdominal ultrasound(χ~2=9.636,P<0.05). Conclusion The combined application of transabdominal ultrasound and transperineal ultrasound can significantly improve the diagnose accordance rate of placenta previa with favorable safety and convenience.It has a higher clinical application value,and it is worthy of promotion and application.
出处
《中国当代医药》
2016年第6期63-66,共4页
China Modern Medicine
关键词
前置胎盘
经腹超声
经会阴超声
Placenta previa
Transabdominal ultrasound
Transperineal ultrasound
