经阴道超声检查在异位妊娠诊断中的应用研究

Transvaginal ultrasonography diagnostic value of ectopic pregnancy

目的 观察阴道超声在异位妊娠诊断中的临床价值.方法 将2010年1月至2013年1月江苏省扬州市妇幼保健院150例孕妇,完全随机分为2组各75例,腹部超声组采用腹部超声检查,阴道超声组采用阴道超声检查,比较2种检查方法的阳性率、超声图像,并比较2组诊断方案对于不同分型异位妊娠检查率.结果 阴道超声组异位妊娠阳性检出率为96.0％（72/75）,腹部超声组异位妊娠阳性检出率为76.0％（57/75）,2组比较差异有统计学意义（P＜0.05）;阴道超声组患者附件包块、胎心搏动、盆腔积液等检出率明显高于腹部超声组,差异均有统计学意义[48.8％（36/75）比28.0％（21/75）、16.0％（12/75）比4.0％（3/75）、52.0％（39/75）比32.0％（24/75）,均P＜0.05];阴道超声组患者破裂型、未破裂型、流产型检出率均明显高于腹部超声组,差异有统计学意义[破裂型：93.3％（42/45）比80.0％（36/45）,未破裂型：100.0％（18/18）比66.7％（12/18）,流产型：100.0％（12/12）比75.0％（9/12）,均P＜0.05].结论 阴道超声在异位妊娠的诊断中效果明显,阳性检出率更高,观察结果准确性更好,明显好于腹部超声,值得临床推广应用.

Objective To examine the transvaginal ultrasonography in the diagnosis of ectopic pregnancy （EP）.Methods All 150 patients with EP from January 2010 to January 2013 were randomly divided into observation group and control group; control group had abdominal ultrasonography and observation group had transvaginal ultrasonography.Results The positive rate of EP was 96.0% in observation group and 76.0% in control group; it was statistically different （P 〈 0.05）.In observation group,accessory bag piece,heart throb,pelvic cavity accumulates fluid were significantly higher than those in the control group; the difference was statistically significant[48.8% （36/75） vs 28.0% （21/75）,16.0% （12/75） vs 4.0% （3/75）,52.0% （39/75） vs 32.0% （24/75）,all P 〈 0.05].Three types of EP with parting were significantly higher than those in control group; the difference was statistically significant[ruptured：93.3% （42/45） vs 80.0% （36/45）,unruptured：100.0% （18/ 18） vs66.7%（12/18）,abortion type：100.0% （12/12） vs75.0%（9/12）,allP〈0.05].Conclusion The positive detection rate is higher with transvaginal ultrasonography and observation accuracy is better than abdominal ultrasonography.