探讨经腹部和经阴道彩色多普勒超声诊断早期异位妊娠的应用价值

Use of transabdominal vs transvaginal color Doppler ultrasound in diagnosis of early ectopic pregnancy

目的:探讨两种不同方式彩超检查诊断患者早期异位妊娠的应用意义。方法:选取2012年1月至2013年12月间本院临床诊断为异位妊娠且住院后经手术以及病理学确诊的83例患者,回顾性分析其入院后采用两种不同方式(经腹部和经阴道)的彩超检测获得的影像学的资料,统计两种彩超方式来诊断出早期异位妊娠的准确率。结果:经腹部彩超检测出异位妊娠的准确率达61.4%;经阴道彩超检测出异位妊娠的准确率达94.0%,两组比较差异有统计学意义(P<0.05);经阴道彩超检测出附件包块、胚芽、宫内假孕囊、盆腔积液、原始胎儿心血管搏动、卵黄囊等影像学的阳性率,各项均大于经腹部彩超,且差异有统计学意义(P<0.05)。结论:早期异位妊娠采用经阴道彩超方式检测获得的影像学阳性率和准确率高于经腹部彩超,推为对早期的异位妊娠进行诊断的超声影像学首选。

Objective： To investigate the clinical significance of two ultrasonography options in diagnosing early ectopic pregnancy. Methods： The study included 83 women who were clinically diagnosed with ectopic pregnancy and confirmed by surgery and pathology in our hospital between January 2012 and December 2013. A retrospective analysis was performed on the color Doppler ultrasound images obtained with either of two different options（ transabdominal and transvaginal）. The diagnostic accuracy of early ectopic pregnancy between the two ultrasonography options was compared statistically. Results： The rate of accuracy in detecting ectopic pregnancy was 61. 4% for transabdominal vs 94. 0% for transvaginal color Doppler ultrasonography,with a significant difference between groups（ P0.05）. Transvaginal ultrasonography performed better in detecting adnexal mass,germ,intrauterine pseudocyesis,pelvic effusion,fetal cardiovascular pulsation and yolk sac,compared with transabdominal option（ P 0. 05）. Conclusion： Imaging with transvaginal ultrasonography may result in better detection and accuracy than with transabdominal ultrasonography,and therefore is recommendable as preferred solution for ultrasound imaging in early diagnosis of ectopic pregnancy.