| 汪华,张文君,宋鑫,贺祎,何晓伟,杨硕,余苗,詹钰.妊娠期完全性子宫破裂超声表现[J].中国医学影像技术,2020,36(3):439~443 |
| 妊娠期完全性子宫破裂超声表现 |
| Ultrasonic features of complete uterine rupture in pregnant women |
| 投稿时间：2019-07-08 修订日期：2020-03-08 |
| DOI：10.13929/j.issn.1003-3289.2020.03.032 |
| 中文关键词: 妊娠 子宫破裂 超声检查 |
| 英文关键词:pregnancy uterine rupture ultrasonography |
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| 中文摘要: |
| 目的 观察妊娠期完全性子宫破裂超声表现。方法 回顾性分析经手术证实的12例完全性子宫破裂患者的临床资料及超声表现。结果 9例有子宫手术史，2例不合理应用引产药，2例骨盆狭窄。共有4种超声表现：①子宫肌壁连续性中断，局部回声紊乱，胎儿及其附属物位于宫腔，腹腔积液；②子宫肌壁连续性中断，胎儿及其附属物部分位于宫腔、部分位于腹腔，腹腔积液；③宫腔未见胎儿及其附属物，胎儿及其附属物位于腹腔，腹腔积液；④合并阔韧带血肿，子宫肌壁连续性中断，腹腔内边界不清、形态不规则的杂乱回声区，无包膜，与子宫肌壁异常回声区相连。12例中，超声明确诊断6例（6/12，50.00％）完全性子宫破裂，4例（4/12，33.33％）可疑子宫破裂，漏诊2例（2/12，16.67％）。结论 完全性子宫破裂超声表现具有一定特征性，能显示破裂类型、位置、大小及腹腔积液情况，可作为诊断完全性子宫破裂的首选影像学方法。 |
| 英文摘要: |
| Objective To observe the ultrasonic features of complete uterine rupture in pregnant women. Methods Clinical data and ultrasonic features of 12 complete uterine rupture patients confirmed by surgical operation were retrospectively analyzed. Results The past medical histories included uterine surgical operation in 9 cases, unreasonable application of drug induced labor in 2 cases and pelvic stenosis in 2 cases. The ultrasonic findings of complete uterine rupture were as follows. ①Interrupted continuity of uterine muscle wall, local echo was disordered, fetus and appendages located in uterine cavity, with different amount of peritoneal effusion. ②Interrupted continuity of uterine muscle wall, the fetus and appendages partially located in the uterine cavity and partially expelled into the abdominal cavity with different amount of peritoneal effusion. ③Empty uterus, the fetus within the amniotic sac was totally expelled into the abdominal cavity with different amount of peritoneal effusion. ④Combined with hematoma of broad ligament, the continuity of uterine muscle wall was interrupted, and there was no capsule in the disordered echo area with unclear boundary and irregular shape in the abdominal cavity, which was connected with abnormal echo area of uterine muscle wall. Among 12 patients of complete uterine rupture, 6 (6/12, 50.00%) cases were correctly diagnosed with ultrasound, while 4 (4/12, 33.33%) cases were suspected and 2 (2/12, 16.67%) cases were misdiagnosed. Conclusion Ultrasonic manifestations of complete uterine rupture have certain characteristics. Ultrasound can be used as the first choice of imaging methods to observe the type, location, size of uterine rupture and abdominal effusion. |
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