产前超声征象评分对前置胎盘合并胎盘植入的诊断价值

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摘要目的探讨产前超声征象评分诊断前置胎盘合并胎盘植入的意义。方法选择2013年5月～2017年4月宜宾市第一人民医院产科收治的186例孕妇作为研究对象。根据临床及病理结果，将186例孕妇分为植入组（64例，前置胎盘合并胎盘植入孕妇）、未植入组（82例，前置胎盘未合并胎盘植入孕妇）和对照组（40例，未合并前置胎盘、胎盘植入孕妇）。64例前置胎盘合并胎盘植入孕妇中粘连型患者24例、植入型患者22例和穿透型患者18例。比较各组和不同胎盘植入分型孕妇产前超声征象评分；用受试者操作特征(ROC)曲线评估产前超声征象评分诊断前置胎盘合并胎盘植入的价值。结果植入组产前超声征象评分高于未植入组和对照组（P ＜ 0.05）；粘连型、植入型和穿透型患者产前超声征象评分组间比较差异无统计学意义（P ＞ 0.05）。经临床及病理结果诊断有64例合并有胎盘植入，经产前超声征象评分诊断有60例合并胎盘植入，产前超声征象评分诊断的灵敏度为93.75%，特异度为96.34%。产前超声征象评分对胎盘植入预测的ROC曲线下面积为0.959。结论产前超声征象评分对前置胎盘合并胎盘植入的诊断有较高的灵敏度和特异度，可为临床诊治提供依据。

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	符珉韩江涛▲

关键词 ：超声征象评分, 前置胎盘, 胎盘植入, 产前诊断

Abstract：Objective To explore the diagnostic clinical significance of prenatal ultrasonographic scoring system in placenta previa with placenta accreta. Methods From May 2013 to April 2017, 186 pregnant women were selected in Department of Obstetrics, the First People′s Hospital of Yibin. According to the clinical and pathological results, they were divided into placenta accreta group (64 cases, placenta previa with placenta increta), non-placenta accreta group (82 cases, placenta previa without placenta accreta) and control group (40 cases, neither placenta previa nor placenta increta). Among 64 cases of placenta previa with placenta implantation, 24 cases were adhesion type, 22 cases were implanted type and 18 cases were penetrating type. The prenatal ultrasonographic scores in the groups were compared. The diagnostic value of prenatal ultrasonographic score in placenta previa with placenta increta was assessed by receiver operating characteristic curves (ROC). Results The score of prenatal ultrasonography in the placenta accreta group was higher than those in the non-placenta accreta group and the control group (P < 0.05). There was no significant difference of prenatal ultrasonography score in adhesive patients, implanted patients and the penetrating patients (P > 0.05). There were 64 cases with placenta accrete by clinical and pathological findings, and there were 60 cases with placenta accrete by prenatal ultrasonographic signs score. The diagnostic sensitivity of prenatal ultrasonographic score was 93.75% and specificity was 96.34%. The diagnostic value of prenatal ultrasonographic signs score in placenta accrete and the ROC was 0.959. Conclusion Prenatal ultrasound imaging score has a high sensitivity and specificity for the diagnosis of placenta previa with placenta accreta, which can provide basis for clinical diagnosis and treatment.

Key words： Ultrasonic sign score Placenta previa Placenta increta Prenatal diagnosis

基金资助:四川省宜宾市卫生局科学技术计划基金资助项目(〔2012〕400号-09)。

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引用本文:

符珉韩江涛▲. 产前超声征象评分对前置胎盘合并胎盘植入的诊断价值[J]. 中国医药导报, 2018, 15(7): 127-130.
FU Min HAN Jiangtao▲. Diagnostic value of prenatal ultrasonographic scoring system in placenta previa with placenta accreta. 中国医药导报, 2018, 15(7): 127-130.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I7/127

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