经阴道超声检测子宫内膜及阻力指数联合血β-HCG在早期诊断宫内外孕中的临床价值

Diagnostic value of testing the thickness and blood flow of uterine endometrium,β-HCG of early intrauterine pregnancy and early ectopic pregnancy

目的:经阴道彩超(TVCD)检测子宫内膜厚度及其阻力指数,结合血β-HCG来更直观、更快地鉴别宫内外早早孕。方法:对470例尿HCG阳性妇女处于早早孕阶段时,先检测其血β-HCG,同时经阴道彩超(TVCD)检测子宫内膜厚度及其阻力指数(R I),检测结果与妊娠最终结果进行对照分析。结果:本组宫内孕的子宫内膜厚度明显大于宫外孕组和宫内早孕自然流产组(P<0.01),内膜显示清晰,显著增厚,厚径常在15 mm以上,呈"葱头样"改变,R I<0.5。宫外孕组内膜居中、增厚不明显,呈"三线征"改变,厚径常小于0.85 cm,R I>0.5。结论:结合血β-HCG检测,用TVCD检测子宫内膜厚度及其阻力指数,并结合宫内和附件区的声像特点预测妊娠部位,为临床提供更有价值的诊断和治疗意见。

Objective： To explore the value of TVCD in testing the thickness and blood flow of uterine endometrium together with β-HCG test for differential diagnosis to both intrauterine pregnancy and ectopic pregnancy at very early stage. Methods： β-HCG were tested, the thickness and blood flow of uterine endometrium in 470 cases of very early pregnancy were tested by TVCD and compared with the last pregnant results. Results： The endometrial thickness of intrauterine pregnancy was significantly thicker than that of ectopic pregnancy and miscarriage （P 〈 0.01 ）. The former was often 〉 1.5 cm, RI 〈 0.5, the latter was often 〈 0.85 cm, RI 〉 0.5. Conclusion： Combined with intrauterine and ultrasonic imaging, TVCD had an important clinical and diagnostic value for the differential diagnosis of early intrauterine pregnancy and early ectopic pregnancy by testing the thickness and blood flow of uterine endometrium together with β-HCG test.