经腹超声与经阴道超声双向检查在早期妊娠诊断中的价值

The application value of transabdominal ultrasound and transvaginal ultrasound examinations in early pregnancy

目的探讨经腹超声和经阴道超声在早期妊娠检查中的应用价值，以便寻找出早期妊娠的最佳检测方法。方法选择停经31～42天，且HCG（人绒毛膜促性腺激素）为阳性或弱阳性，疑似早期妊娠的122例患者，年龄19～40岁，平均27．6岁，均行经腹超声和经阴道超声检查，分别观察子宫、妊娠囊、胚芽、胎心的情况，针对两次的检测结果进行比较。结果122例患者中，经腹超声检测出妊娠囊、卵黄囊91例，检出率达到74．6％；经阴道超声检测出妊娠囊、卵黄囊120例，检出率达到98．4％。经腹超声检测出胚芽者58例，经阴道超声检测出胚芽者80例，经阴道超声与经腹超声相比可以更早检测出胚芽。在同时检测出胚芽的52例中，经腹超声的胎心检出率为23．1％，经阴道超声的胎心检出率为53．8%，经阴道超声与经腹超声相比胎心检出时间可以提前1周。结论经阴道超声检测早期妊娠的灵敏度和准确性高于经腹超声，经腹超声和经阴道超声相结合是临床检测早期妊娠安全、准确的方法。

Objective To investigate the application value of transabdominal ultrasound and transvaginal ultrasound ex aminations in early pregnancy, so as to find out the best clinical detection method of early pregnancy. Methods 122 cases, aged 19 to 40 years and averaged 27.6 years, postmenopausal in 31-42 days, and the HCG （human chorionic gonadotro pin） as positive or weakly positive, who were suspected uterus early pregnancy, were examined by both transabdominal ul trasound and transvaginal ultrasound. The gestational sac, embryo, and fetal heart were observed respectively. Results Transabdominal ultrasound detected 91 patients with the gestational sac, and the detection rate was 74.6%. Transvaginal ultrasound detected 118 cases with the gestational sac, the detection rate was 98.4%. Transabdominal ultrasound detected 58 patients with germ, and transavaginal ultrasound detected 79 patients with germ. In 52 patients detected the germ by two ultrasonographies, detectable rate of fetal heart was 23.1 for transaabdominal ultrasound, while transvaginal ultra sound was 53.8%. Transvaginal ultrasound compared with transabdominal ultrasound, detectable time of fetal heart can be one week in advance. Conclusion Transvaginal ultrasound examination is more sensitive than transabdominal ultra sound examination. Transvaginal ultrasound is a safe and accurate method, and should be combined with transabdominal ultrasound in the early pregnancy diagnosis.