经阴道彩色多普勒能量图超声结合血β-hCG对“妊娠盲区”的监测

Monitoring of pregnancy blind spot by transvaginal color Doppler power imaging ultrasonography combined with serum β-hCG detection

目的：探讨经阴道彩色多普勒能量图超声结合血β-hCG在“妊娠盲区”中的应用价值。方法：对120例尿妊娠实验阳性或弱阳性，孕周约32～42天的早早孕患者检查TV—CD和血β-hCG。结果：宫内早早孕子宫内膜动脉阻力指数（RI）〈0．5，宫内早早孕流产型RI〉0．5，二者比较差异有统计学意义（P〈0．01），宫外早早孕子宫内膜未见明显局限性动脉血流信号，而有一小部分RI〉0．5，多数见静脉血流信号或无血流信号显示。48h后复查．宫内早早孕流产组、宫外早早孕组与宫内早早孕组差异有统计学意义（P〈0．01）；而二者比较差异无统计学意义（P〉0．05）。血β-hCG宫内旱早孕组与宫内早早孕流产组、宫外早早孕组比较差异有统计学意义（P〈0．01），宫外早早孕组与宫内早早孕流产组比较差异无统计学意义（P〉0．05），48h后复查，宫内早早孕流产组与宫内、外早早孕组比较差异有统计学意义（P〈0．01）。结论：经阴道彩色多普勒能量图结合血β-hCG联合应用能预测妊娠的趋向，提示妊娠的着床部位，为临床早诊断、早治疗、避免误诊提供一个有价值的临床诊断方法。

Objective： To explore the application value of transvagJnal color Doppler power imaging ultrasonography combined with serum β-human chorionic gonadotropin （β-hCG） detection in the monitoring of pregnancy blind spot. Methods： 120 very early pregnant women with weak positive or positive urine pregnancy test, 32 -42 gestational days received transvaginal color Doppler power imaging ultra- sonography, and the level of β-hCG was detected. Results： The resistant indexes （RI） of blood flow for uterine spiral artery was under 0. 4 and over 0. 5 in very early intrauterine pregnancy group and spontaneous abortion group, there was significant difference （ P 〈 0. O1 ） ; there was no obvious local artery blood flow signal in very early ectopic pregnancy, but a little RI 〉 0. 5, most of the patients showed vein blood flow signals. After 48 hours, there was significant difference between very early intrauterine pregnancy combined with spontaneous abortion group, very early ectopie pregnancy group and very early intrauterine pregnancy group （P 〈 0. 01 ） , but there was no difference between very early intrauterine pregnancy combined with spontaneous abortion group and very early ectopie pregnancy group （ P 〉 0. 05 ） . There was significant difference in serum β-hCG level between very early intrauterine pregnancy combined with spontaneous abortion group, very early ectopic pregnancy group and very early intrauterine pregnancy group （P 〈 0. 01 ）, but there was no difference between very early intrauterine pregnancy combined with spontaneous abortion group and very early ectopic pregnancy group （ P 〉 0. 05 ） . After 48 hours, there was significant difference between very early intrauterine pregnancy combined with spontaneous abortion group and the other two groups （ P 〈 0. 01 ） Conclusion： Transvaginal color Doppler power imaging uhrasonography combined with serum β- hCG detection can predict pregnancy trend, point out pregnancy region and provide a valuable method for early diagnosis, early treatment and avoiding misdiagnosis.