妇产科急腹症的超声临床诊断及鉴别分析

Analysis of obstetrics and gynecology ultrasound clinical diagnosis and the differential value of acute abdominal pain

目的分析妇产科急腹症的超声临床诊断及鉴别价值.方法：回顾性选择我院经手术病理检查确诊的108 例异位妊娠患者和26 例卵巢黄体破裂患者为研究对象.对比分析两组患者的超声检查表现及特征,包括超声成像表现、血流定量分型特征、血流频谱阻力指数（RI 值）及血流频谱特征等.结果：在超声成像上,并无明显的特征用于二者的鉴别诊断;但在血流定量分型特征上,异位妊娠组患者条状型与点状型血流总比例为70.37%,明显高于黄体破裂组的11.54%（P〈0.05）.同时,异位妊娠组患者RI 值低于黄体破裂组（P〈0.05）;且在血流频谱特征上,异位妊娠组患者极低阻力型血流频谱、无舒张期血流频谱均明显高于黄体破裂组（P 均〈0.05）,但低阻力型血流频谱明显低于黄体破裂组（P〈0.05）.结论：针对不典型异位妊娠及卵巢黄体破裂,在超声成像表现缺乏有力的鉴别特征时,可通过血流显像及频谱特征的对比分析予以二者鉴别诊断,以提高临床诊断正确率.

objective to analysis of obstetrics and gynecology ultrasound clinical diagnosis and the differential value of acute abdominal pain. Methods： our hospital’sconfirmed by surgery pathology examination of 108 patients with ectopic pregnancy and 26 patients with ovarian corpus luteum rupture were selected as the research object.Ultrasound manifestations and characteristics of two groups of patients, including ultrasonic imaging performance, blood flow quantitative classification characteristics, blood flowspectrum resistance index （RI） and blood flow spectrum features were compared. Results： on the ultrasonic imaging, and had no obvious characteristics used in the differentialdiagnosis of the two; But in blood flow quantitative classification characteristics, ectopic pregnancy patients strip type and dot type blood total percentage was 70.37%, significantlyhigher than the 11.54% of the corpus luteum rupture group （P 〈 0.05）. At the same time, the group of patients with ectopic pregnancy RI value was lower than the corpus luteumrupture group （P 〈0.05）; And on the blood flow spectrum features, ectopic pregnancy patients extremely low resistance of blood flow spectrum, no diastolic blood flow spectrum weresignificantly higher than that of corpus luteum rupture group （P 〈 0.05）, but low resistance type blood flow spectrum was lower than that in group corpus luteum rupture （P 〈 0.05）.Conclusion： in view of the atypical ectopic pregnancy and ovarian corpus luteum rupture in the identification features of ultrasonic imaging performance lack of strong, can throughblood flow imaging and spectrum characteristics of comparative analysis to the two differential diagnoses, in order to improve clinical diagnosis accuracy.