不同B超检查对妇科急腹症的诊断价值

Evaluation on Different B-ultrasonic Examinations in the Diagnosis of Gynecologic Acute Abdomen

目的了解经腹B超检查、经阴道B超检查和经腹经阴道联合B超检查方法对妇科急腹症的诊断价值。方法选取2010年1月至2012年12月在廊坊市第四人民医院就诊的妇科急腹症患者291例,均进行经腹及经阴道B超平行检查,以术后病理和临床表现确证结果为金标准,观察不同B超检查方法对不同急腹症的诊断准确率和与临床确诊结果的符合率。结果经腹联合经阴道B超对卵巢囊肿蒂扭转的诊断准确率为95.3%,高于单纯经腹、经阴道B超检查的74.4%和79.1%(P<0.05),经腹联合经阴道B超对急性盆腔炎的诊断准确率为96.7%,高于单纯经腹、经阴道B超检查的70.0%和76.7%(P<0.05)。经腹联合经阴道B超与临床确诊结果符合率为93.8%,高于经腹和经阴道B超检查的83.2%和88.7%(P<0.05)。结论经腹联合经阴道B超对几种常见妇科急腹症的诊断效果优于单纯经腹或经阴道B超检查,具有较高的临床应用价值。

Objective To understand the clinical value of transabdominal B-ultrasonic examination, transvainal B-ultrasonic examination, and transabdominal combined with transvaginal B-ultrasonic examination in the diagnosis of gynecologic acute abdomen. Methods A total of 291 cases of patients with gynecdogic acute abdomen admitted in the Fourth People＇s Hospital of Langfang from Jan. 2010 to Dec. 2012 were selected and parallel examined with transabdominal and transvaginal B-ultrasound. The accuracy of B-ultrasound diagnosis and clinical diagnosis coincidence rate were observed according to the postoperative pathology and clinical manifestation as ＇the golden standard＇. Results The diagnostic accuracy rate of oyarian cyst torsion by transabdominal combined with transvaginal B-ultrasonic examinationwas 95. 3%, significantly higher（ P 〈 0.05 ） than solely by transabdominal （ 74.4% ） and transvaginal B-ultrasonic examination （79.1% ）. The diagnostic accuracy rate of acute pelvic inflammatory disease by transabdominal combined with transvaginal B-ultrasonic examination was 96.7%, significantly higher （ P 〈 0. 05 ） than solely by transabdominal（70.0% ）and transvaginal B-ultrasonic examination（76.7% ）. The clinical diagnosis coincidence rate of the combined B-ultrasonic examination was 93.8% , significanflyhigher（ P 〈 0.05 ） than solely by transabdominal（ 83. 2% ） and transvaginal B-ultrasonic examination （ 88.7% ）. Conclusion The diagnostic result of transabdominal combined with transvainal B-ultrasonic examination for patients with gynecdogic acnte abdomen is better than that of the single transabdominal or transvaginal B-ultrasonic examination.