阴道超声联合腹部B超在宫外孕诊断上的应用价值

Application value of transvaginal ultrasound combined with abdominal B ultrasound in the diagnosis of ectopic pregnancy

目的探讨阴道超声联合腹部B超在宫外孕诊断上的应用价值,为宫外孕的早期诊断提供依据。方法对本院2011年12月至2013年12月收治的106例经手术或保守治疗确诊宫外孕患者的临床资料进行回顾性分析,全部患者均行阴道超声及腹部超声检查,观察患者卵巢子宫旁有无异常,并对比阴道超声检查、经腹部B超检查以及二者联合检查宫外孕的阳性率及漏诊率情况。结果经腹部B超检测卵黄囊、胎芽、心搏和盆腔积液等阳性检出率均显著低于经阴道超声检查(P<0.05);阴道超声和腹部超声联合诊断为宫外孕者101例,诊断符合率为95.28%,漏诊5例占4.72%;单纯腹部超声诊断宫外孕79例,诊断符合率为74.53%,漏诊27例占25.47%;单纯阴道超声检查诊断为宫外孕者82例,诊断符合率为77.36%,漏诊24例占22.64%,阴道超声联合腹部B超与单纯腹部超声和单纯阴道超声比较,其诊断符合率差异均有统计学意义(P<0.05),但阴道超声诊断符合率和腹部B超诊断符合率相近,差异无统计学意义(P>0.05)。结论阴道超声联合腹部B超可显著提高宫外孕的诊断符合率,为临床提供了更方便、更快捷的诊断手段,提高了诊断的准确率,值得临床推广应用。

Objective To investigate the application value of transvaginal ultrasound combined with abdominal B ultrasound in the diagnosis of ectopic pregnancy, and provide guidance for early diagnosis of ectopic pregnancy. Methods The clinical data of 106 patients confirmed by surgery or conservative treatment as ectopic pregnancy in our hospital during December 2011 to December 2013 were analyzed retrospectively. All patients underwent transvagi- hal ultrasound and abdominal ultrasound to observe the abnormality in ovaries and para-uterine area, and then the posi- tive rate and misdiagnosis rate of ectopic pregnancy were compared between patients examined by transvaginal ultrasound, abdominal B ultrasound and combined ultrasound. Results The detection rate of yolk sac, fetal bud, cardiac and pelvic effusion in abdominal B was significantly lower than that in transvaginal sound （P〈0.05）. 101 cases ofecto- pic pregnancy were diagnosed by the combined ultrasound, where the diagnosis rate and misdiagnosis rate were 95.28% and 4.72% respectively. Meanwhile, 79 cases of ectopic pregnancy were diagnosed by abdominal ultrasound alone, where the diagnosis rate and misdiagnosis rate were 74.53% and 25.47% respectively. There were 82 eases of eetopie pregnancy were diagnosed by transvaginal ultrasound alone with diagnose rate of 77.36% and misdiagnosis rate of 22.64%. There were statistically significant difference between combined ultrasound and wansvaginal ultrasound or abdominal ultrasound alone （P〈0.05）. However, there was no statistically significant difference between transvaginal ultrasound and abdominal ultrasound （P〉0.05）. Conclusion The transvaginal ultrasound combined ab- dominal B can significantly improve the diagnosis effect of ectopie pregnancy, which provides a more convenient and efficient diagnostic tool with a higher accuracy for diagnosis. Therefore, it is worthy of clinical application.