腹部超声和阴道超声在诊断异位妊娠中的价值比较

Value of abdominal ultrasound and transvaginal ultrasound on diagnosis of ectopic pregnancy

目的：比较 TAS（腹部超声）和 TVS（阴道超声）在异位妊娠临床诊断中的应用价值。方法选择驻马店市中心医院2011年4月至2013年4月收治74例的异位妊娠患者的临床资料进行回顾性分析,根据诊断方法的不同分为 TAS 组和 TVS 组。比较两组声像特征、敏感性与特异性。结果 TAS 组宫外混合性团块、宫外疑似孕囊影、外孕囊影可见胚芽与胎心等声像特征确诊率均显著高于 TVS 组,差异有统计学意义（P 〈0．05）。 TAS 组38例患者中发生2例漏诊和1例误诊,敏感性与特异性分别为94．7%（36/38）、97．4%（37/38）, TVS 组分别为80．6%（29/36）、88．9%（32/36）,TAS 组敏感性显著高于 TVS 组（P 〈0．05）,特异性比较差异未见统计学意义（P 〉0．05）。结论 TAS 与 TVS 诊断异位妊娠均有较高确诊率,其中 TAS 更适用于急诊患者,而 TVS 则在稳定型异位妊娠中的诊断中有更大优势,需结合患者实际情况选择合适诊断方法,有条件患者可结合 HCG 检查结果及 TAS、TVS 联合检查来避免漏诊情况。

Objective To compare the application value of TAS （ abdominal ultrasound） and TVS（transvaginal ultrasound） in the clinical diagnosis of ectopic pregnancy. Methods From April 2011 to April 2013,74 cases of ectopic pregnancy were analyzed retrospectively in Zhumadian Central Hospital according to different diagnostic methods, the 74 cases were divided into TAS group and TVS group. The ultrasonographic characteristics, sensitivity and specificity of the two groups were compared. Results In TAS group, the ectopic mixed mass, ectopic suspected gestational sac shadow, the characteristic diag-nosis rates such as outside the gestational sac shadow visible embryo and fetal heart were significantly higher than those of TVS group, the differences were significant （ P 〈 0. 05）. Among the 38 cases in group TAS, 2 cases had missed diagnosis and 1 case had misdiagnosis, the sensitivity and specificity was respectively 94. 7% （36 / 38）, 97. 4% （37 / 38）, those in TVS group was 80. 6% （29 / 36）, 88. 9%（32 / 36）, group TAS was more sensitive than TVS group （P 〈 0. 05）, there was no significant difference in specificity between the two groups （P 〉 0. 05）. Conclusions TAS and TVS in diagnosis of ectopic pregnancy has high diagnosis rate, in which the TAS is more suitable for emergency patients, and TVS have more advantages in diagnosis of stable in ectopic pregnancy, choose the right diagnosis method com-bining with the actual situation of patients, the patients can be combined with the conditional test results of HCG and combined with TAS, TVS check to avoid leakage diagnosis.