彩色多普勒超声在妇科急腹症鉴别诊断中的应用价值

Application Value of Color Doppler Ultrasonography in Differential Diagnosis of Gynecologic Acute Abdomen

目的探讨彩色多普勒超声在妇科急腹症鉴别诊断中的应用价值。方法方便选取2015年9月—2017年3月在该院就诊的妇科急腹症患者93例,均行经阴道及腹部彩色多普勒超声诊断,与病理诊断结果为对照,统计鉴别诊断的符合率。结果联合超声诊断符合率(95.70%)明显高于经阴道超声诊断符合率(87.10%)及腹部超声诊断符合率(86.02%),差异有统计学意义(P<0.05);经病理诊断结果 ,93例妇科急腹症患者中卵巢子宫内膜异位囊肿4例,卵巢囊肿蒂扭转7例,不完全流产13例,黄体囊肿破裂9例,急性盆腔炎26例,异位妊娠34例,其中联合超声诊断中卵巢囊肿蒂扭转符合率为85.71%(6/7),黄体囊肿破裂符合率88.89%(8/9),不完全流产符合率92.31%(12/13),异位妊娠符合率为97.06%(33/34),急性盆腔炎为100.00%(26/26),子宫内膜异位症为100.00%(4/4)。结论彩色多普勒超声鉴别诊断妇科急腹症具有较高的诊断符合率,为后期制定治疗方案提供依据。

Objective This paper tries to explore the application value of color Doppler ultrasonography in differential diagnosis of gynecologic acute abdomen. Methods 93 cases of patients with gynecologic acute abdomen from September 2015 to March 2017 in this hospital were convenient selected and treated by transabdominal and transvaginal color Doppler ultrasound diagnosis and then compared with the pathological diagnosis results, the differential diagnosis coincidence rate were concluded. Results The coincidence rate of ultrasound diagnosis was 95.70%, significantly higher than that of transvaginal ultrasound diagnosis coincidence rate of 87.10% and abdominal ultrasound diagnosis coincidence rate of 86.02%, the difference was statistically significant(P<0.05); the results of pathological diagnosis showed that 4 cases of patients with ovarian endometrial cyst among the 93 cases of gynecologic acute abdomen, 7 cases of ovarian cyst torsion, 13 cases of incomplete abortion, 9 cases of rupture of corpus luteum cyst, 26 cases of acute pelvic inflammatory disease, 34 cases of ectopic pregnancy, and the coincidence rate of combined ultrasound in the diagnosis of ovarian cyst torsion was 85.71%(6/7); the coincidence rate of rupture of corpus luteum cyst of 88.89%(8/9), incomplete abortion coincidence rate was 92.31%(12/13),ectopic pregnancy coincidence rate was 97.06%(33/34), acute pelvic inflammatory disease was 100.00%(26/26), endometriosis was 100.00%(4/4). Conclusion Color Doppler ultrasonography has a high diagnostic accuracy in differential diagnosis of gynecologic acute abdomen, and provides a basis for the establishment of treatment program in the late stage.