经阴道、经腹彩色多普勒超声在异位妊娠中的诊治价值

Pervaginal,Abdominal Color Doppler Ultrasound in Ectopic Pregnancy Diagnosis Value

目的:探讨经阴道、经腹彩色多普勒超声在诊治异位妊娠中的价值。材料与方法:采用经阴道、经腹彩色多普勒超声检查对113例异位妊娠,观察子宫内膜的厚度;宫腔内有无假孕囊;包块的位置、大小、形态、内部回声、与卵巢的关系及血流分布情况;盆腔内有无积液;保守治疗的患者,观察治疗前、后包块大小及彩色血流的分布情况。结果:113例异位妊娠中,输卵管妊娠98例(输卵管壶腹部妊娠91例,输卵管峡部妊娠5例,输卵管间质部妊娠1例,输卵管伞部妊娠1例),宫角妊娠12例,卵巢妊娠2例,误诊1例(输卵管侵蚀性葡萄胎破裂);经手术治疗70例(诊断符合率98.5%);经保守治疗57例,其中14例保守治疗失败后手术。结论:经阴道超声检查图像清晰,对判断附件区病灶的来源起重要的作用,是诊断异位妊娠的首选检查方法,尤其小病灶的早期诊断,在异位妊娠保守治疗中具有重要意义;对输卵管位置高、包块大,超出经阴道探头所能扫查范围的,还需联合使用经腹探查,可完全显示包块的大小范围及腹腔积液分布的情况,为临床采取何种治疗方案提供可靠的依据。

Purpose ： To investigate the pervaginal, abdominal color Doppler ultrasound in the diagnosis and treatment of ectopic pregnancy in the value. Materials and Methods： using pervaginal, abdominal color Doppler uhrasound examination of 113cases of ectopic pregnancy, to observe endometrial thickness; intrauterine gestational sac without; mass location, size, shape, internal echo, together with ovarian relations and blood flow distribution ; the pelvic cavity inner condition of effusion; observation mass size and blood flow chang of cases with expectant treatment . Results： within 113cases of ectopic pregnancy, 98 cases of fallopian tube pregnancy （graviditas ampullaris 91 cases, graviditas tubaria isthmica; isthmic pregnancy 5 cases, interstitial tubal pregnancy 1 cases, fimbriae tubae pregnancy 1 cases ） , 12 cases of cornual pregnancy, 2 cases of ovarian pregnancy, 1 cases were misdiagnosed （ fallopian tube invasive hydatidiform mole rupture） ; 70 cases of operation treatment （diagnose accordance rate 98. 5% ） ; 57 cases of expectant treatment, including 14 cases of failure with conservative treatment to operation treatment. Conclusion： pervaginal ultrasonograph image clarity, to judge the attachment area lesions sources plays an important role in the diagnosis of ectopic pregnancy, is the preferred inspection method, especially small lesions in the early diagnosis on the conservative treatment of eetopic pregnancy, has important significance ; on the fallopian tube position, mass, beyond the transvaginal probe can scan range, also combined with abdominal exploration, can fully display mass size range and peritoneal effusion distribution, taking the treatment scheme for clinical provide reliable basis.