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Objective To explore the value of two dimentional colour Doppler flow image (2D-CDFI) combined with three-dimensional color power angiography (3D-CPA) in diagnosis of placenta accreta.Methods A total of 43 pregnant women at risk of placenta accreta selected from September 2010 to August 2015 were enrolled,and underwent 2D-CDFI and 3D-CPA to scan entire placenta.Taking the results of clinical outcome and delivery pathology of the placenta as standard,the ultrasound characteristics of 2D-CDFI and 3D-CPA were analyzed.Results Taking the results of clinical outcome and delivery pathology of the placenta as standard,24 were proved with placenta increta,3 patients with adherent placenta,2 patients with placenta percreta,14 patients with no placenta implantation.Out of 43 cases,29 cases displayed the placental thickening and rich blood vessels in placenta,and at interface of placenta and bladder wall in 2D-CDFI.For 2D-CDFI,19 cases were correctly diagnosed with placenta accrete,while 6 cases were mis-diagnosed and 4 cases missed diagnosed,the diagnosis coincidence rate by 2D-CDFI was 65.5％ (19/29).The ultrasound characteristics displayed irregular arranged myometrial arcuate artery,rich blood vessels at interface of placenta and bladder wall in 3D-CPA.For 3D-CPA,23 cases were correctly diagnosed with placenta accrete,3 cases were misdiagnosed,the diagnosis coincidence rate by 3D-CPA was 79.3％ (23/29).For 3D-CPA combined 2D-CDFI,1 case missed diagnosed,the diagnosis coincidence rate by combination 2D-CDFI with 3D-CPA was 96.6％ (28/29).Conclusions Placenta accrete can all be prenatally diagnosed by characteristic ultrasonic features of 2D-CDFI and 3D-CPA.But 3D-CPA can clearly display the range of placenta accrete lesions and the depth of the blood vessels diffused,has more advantage than two-gray scale ultrasound and 2D-CDFI and has broad application in clinic.
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Objective To investigate the correlation between self-nursing and the quality of life,thereby provide the basis of enhancing the patients' quality of life.Methods A total of 119 patients with type 2 diabetes metillus (T2DM) in the People's Hospital of Changyi City,Shandong Province,were selected,then they were investigated with Exercise of Self-care Agency Scale (ESCA) and Diabetes Specific Quality of Life Scale (DSQL).The correlations between self-nursing and the quality of life were analyzed.Results The self-nursing total score in 118 efficient patients was (108.36±21.94),and the low level,intermediate level and high level accounted for 2.54％ (3/118),64.41％ (76/118) and 33.05％ (39/118),respectively.The total score of DSQL was (69.95±9.74),among all factors,physiology and mentality played a significant role in the quality of life.According to Pearson correlation analysis,the self-nursing ability and the quality of life was positively correlated.Conclusions In the process of nursing intervention to T2DM,nurses should value the improvement of self-nursing ability,solidify the correct awareness of T2DM,eventually to elevate the quality of life.
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Objective To analyze the ultrasonographic features of fetal palate in the second and third trimester. Methods Two-dimensional ultrasound was performed in 1 885 fetuses during 21 to 36 gestational weeks of pregnancy, including 1 023 cases in 2nd trimester and 862 cases in 3nd trimester. The normal fetal palate ultrasound images were conifrmed by postnatal examination. In the ultrasound examination, fetal palate coronary plane was scanned through submandibular region, oral ifssure and prootic region;longitudinal plane was scanned through oral ifssure. The detection rate of completely and continuously displayed fetal palate was calculated. Results In prenatal ultrasonography, the normal fetal hard palate was shown as a bright band and the normal soft palate as a hypoechoic band in coronary section through fetal submandibular region, oral ifssure and prootic region. The detection rate was 76%(777/1 023)in 2nd trimester group and 53%(458/862) in 3rd trimester group. The normal fetal palate was shown as continuous camber echogenic band in longitudinal plane through oral ifssure. The detection rate was 49%(501/1 023) in 2nd trimester group and 13%(113/862) in 3rd trimester group. The detection rate was 94%(961/1 023) in 2nd trimester group and 56%(483/862) in 3rd trimester group by the combination of two scanning approaches. Conclusions There is usually an obvious gap between mandible gristles in 2nd trimester fetus. Fetal palate is accessible regardless of fetal head position by coronary scanning through submandibular region, oral ifssure and prootic region and longitudinal scanning through oral ifssure. These planes could display fetal palate well, and might be useful in detecting isolated secondary cleft palate. But these scanning approaches and planes might not suitable for routine screening due to operator dependence.
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Objective To explore the application value of ultrasound in the diagnosis and treatment for cesarean scar pregnancy. Method The ultrasonic features, clinical treatment of 42 cases of cesarean scar pregnancy were reviewed retrospectively. Results Among 42 patients,35 patients (83.3% ,35/42) were diagnosed accurately by ultrasound. The sonographic appearance showed 15 cases were gestational sac-type and 22 cases were mixed mass-type,the other 5 cases were classified into type three in which the gestational sac mostly located at the uterine cavity and only the inferior part implanted in the cesarean scar. Uterine artery embolisation and suction curettage with the sonographic guidance with 2 cases, intra-amniotic administration of MTX under sonographic guidance with 15 cases, expectant treatment with 20 cases or complex treatment with 5 cases. During treatment,ultrasonography showed focus of infection was shrinked gradually and blood flow disappeared, blood (3 -human chorionic gonadotrophin was decreased to normal level. ConclusionUltrasound can diagnose cesarean scar pregnancy promptly and accurately, proportionate treatment would be selected according to the type of cesarean scar pregnancy, and also can evaluate the therapeutic effect.