经腹部与经阴道超声在输卵管妊娠诊断中的运用比较

Comparison of transabdominal and transvaginal sonography in the diagnosis of tubal pregnancy

目的探讨经腹部与经阴道超声在输卵管妊娠诊断中的运用比较。方法对201例经手术及病理确诊的输卵管妊娠患者,经腹部(TAS)、经阴道(TVS)以及经腹部与经阴道二者结合的(TAS+TVS)超声声像图和临床资料进行回顾性分析。结果 TAS 67例诊断符合率65.3%,漏诊率19.5%,误诊率15.2%;TVS 67例诊断符合率82.2%,漏诊率9.2%,误诊率8.6%;TAS+TVS 67例诊断符合率96.4%,漏诊率1.8%,误诊率1.8%。TAS+TVS对附件区包块、卵黄囊、胚芽、原始心管搏动、宫内假孕囊及卵巢的检出率远较TAS、TVS高,差异有统计学意义(P<0.05)。结论采用经腹部与经阴道二者结合的超声检查方法比仅经腹部或仅经阴道的方法诊断准确率高,误诊或漏诊率低,值得推广。

Objective To compare of transabdominal sonography （TAS） and transvaginal sonography（TVS） in the diag- nosis of tubal pregnancy. Methods TAS or TVS or TAS and TVS findings and clinical data of 201 cases of tubal pregnancy con- finned by operation and pathological results were analyzed retrospectively. Results Among of the 67 TAS cases, the concordance was 65.3%, missed diagnosis rate was 19. 5%, misdiagnosis rate was 15. 2% ; among of the 67 TVS cases, the concordance was 82. 2%, missed diagnosis rate was 9. 2%, misdiagnosis rate was 8. 6% ; among of the 67 TAS and TVS cases, the concordance was 96. 4%, missed diagnosis rate was 1.8%, misdiagnosis rate was 1.8%. The incidence rate of adnexal masses,yolk sac, germ,primitive heart tube pulse,empty sac pregnancy and ovary by TAS and TVS was higher than those of diseases by TAS or TVS （P 〈 0. 05）. Conclusion The accuracy of TAS and TVS was higher than TAS or TVS respectively, missed diagnosis rate or mis- diagnosis rate were lower, the method should be worth to a wide application.