超声诊断早期输卵管异位妊娠的临床观察分析

Clinical Observation on Ultrasound Diagnosis of Early Oviduct Ectopic Pregnancy

目的探讨超声波在诊断早期输卵管异位妊娠的临床应用价值。方法选择30例有阴道不规则流血、疑似输卵管异位妊娠患者,使用超声进行早期诊断,再与临床诊断(包括临床表现、手术结果及病理结果)进行对照分析。同时比较腹壁超声与阴道超声的不同诊断效果。结果 30例病例经超声诊断均为输卵管异位妊娠,其超声检查结果为:7例超声探及孕囊样无回声,4例探及有稍强回声环,6例合并宫内假孕囊回声,5例见血流环绕,18例见混合回声包块。有19例探及腹腔、盆腔积液。手术及病理结果证实,30例均系输卵管异位妊娠,包括未破裂型输卵管妊娠、流产型输卵管妊娠及破裂型输卵管妊娠。阴道与腹壁两种超声检查方法对附件包块、血流及盆腔积液的检出,差异有统计学意义(P<0.05)。结论超声早期诊断检查结果与临床诊断结果一致,认为超声诊断检查早期输卵管异位妊娠结果准确,有临床应用价值。同时认为阴道检查比腹壁检查更准确。

Objective To explore the clinical value of ultrasound in the diagnosis of early oviduct ectopic pregnancy. Methods Thirty anomalistic vaginal bleeding patients with suspected tubal ectopic pregnancy were examined by ultrasound for early diagnosis.And the results of ultrasound were compared with their clinical diagnoses,including clinical manifestations,surgical results and pathological results.Simultaneously,the diagnosis effect of abdominal ultrasound and transvaginal sonography was compared. Results Thirty patients were diagnosed with tubal ectopic pregnancy by ultrasound probe,including 7 patients with anechoic gestational sac-like,4 patients with slightly stronger echo ring,6 patients with combined intrauterine pseudopregnancy sac echo,5 patients with blood flow around,and 18 patients with mixed echoic mass.19 patients had abdominal and pelvic effusion.The surgical and pathological results confirmed that all the patients suffered from tubal ectopic pregnancy,including unruptured tubal pregnancy,miscarriage tubal pregnancy and ruptured tubal pregnancy.There were statistically significant differences in the detection of adnexal masses,blood flow and pelvic effusion between abdominal ultrasound and transvaginal sonography（P0.05）. Conclusions The early diagnoses results of ultrasound examinations are consistent with the results of clinical diagnoses.The result of ultrasound examination of early tubal ectopic pregnancy is accurate and has clinical value.At the same time,it is considered that transvaginal sonography is more accurate than abdominal ultrasound.