胎盘植入的超声诊断价值.pdf

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1、EffectivenessofApplicationofUltrasoundinDiagnosisofPlacentaAccretas周凤英。郑华，张伟[摘要】目的探讨彩色多普勒超声对胎盘植入的产前、产后诊断价值。方法回顾性分析手术证实北京市朝阳区妇儿医院功能科的3O例胎盘植入患者的二维声像图及多普勒血流显像特点，观察子宫肌壁厚度、胎盘内部回声、北京100021胎盘后方与子宫肌壁问回声，并对胎盘实质内及胎盘后方血流作综合分析。结果3O例胎盘植入患者，产前诊断6例，诊断符合率为20％(6／30)，漏诊24例，漏诊率为80％(24／30)。前壁胎盘14例，产前检出5例，检出率为35．7％；非

2、前壁胎盘16例，检出1例，检出率6．2％；合并前置胎盘6例，检出4例，检出率为66．7％。结论合并前置胎盘的胎盘植入产前诊断率较高，其他部位诊断率较低；产后胎盘残留声像图明显，结合彩色血流能够明确胎盘植入。【关键词】胎盘植入；彩色多普勒超声；产前诊断Abstract：ObjectiveToexploretheeffectivenessofapplicationofCDU(ColorDopplerUltrasound)inprenatalandpostnataldiagnosisofplacentaaccretas．MethodsThetwo—dimensionalsonographica

3、ndCDFI(ColorDopplerFlowImaging)manifestationsof30placentaaccretapatientswhohadbeenconfirmedbysurgerywereretrospectivelyanalyzed．Then，thethicknessoftheuterinemusclewallaswellastheechosoftheintro-placentalandretro—placentalregionsandtheuterinemusclewallwasobserved；andcomprehensiveanalysisoftheblood

4、flowintheplacentalparenchymaandretro-placentalregionswasalsomade．ResultsAmong30casesofplacentaaccretas，therewere6casesofprenataldiagnosisforplacentaaccreta(TheRateofDiagnosis：20％(6／30))；24casesofmisdiagnosis(TheRateofMisdiagnosis：80％(24／30))．Moreover,among14casesofanteriorplacentas，5caseswerepren

5、atallydiagnosed(TheDetectionRate：35．7％)．Andamongsixcasesoftheanteriorplacentacomplicatedwithplacentaprevia，4casesweredetected(TheDetectionRate：66．7％、．ConclusionTherateofprenataldiagnosisfortheanteriorplacentacomplicatedWimplacentapreviaWashigherthanthatforotherregions．Theresidueofpostnatalplacent

6、ashadanobvioussonogram．CombinedapplicationofCDFIandCDUcanbeusedforidentificationofplacentaaccretas．ZHOUFeng-ying，ZHENGHua，Keywords：placentaaccretas；colordopplerultrasound；prenataldiagnosisZHANGWeiDepartmentofFunction，Chaoyang[中图分类号]R445．1；R714．43[文献标志码]BWomen’SandChildren’SHospital，Beijingdoi：10．

7、3969／j．issn．1674-1633．2015．04．0171O0021．China[文章编号]1674—1633(2015)04—0058—03胎盘植入是产科严重的并发症，为胎盘绒毛穿入宫壁初产妇14例，经产妇16例，孕周13～4O周，既往有剖肌层。目前研究认为，人工流产、前置胎盘、剖宫产史是宫产史9例，3次以上刮宫史10例，前置胎盘6例，所有导致孕妇发生胎盘植入的主要危险因素]。目前彩色多普病例均经病理证实。勒超声是临床检