超声诊断妇科急腹症的临床应用及误诊原因分析

Clinical application of ultrasonic diagnosis in gynecological acute abdomen and misdiagnosis causes analysis

目的研究超声诊断对妇科急腹症的诊断价值。方法选取2014年2月至2015年2月海南三亚市人民医院急诊科收治的疑患妇科急腹症的108例女性患者,采用腹部联合阴道超声检查,以手术病理或临床医师最终诊断为准,判断两种检查及联合检查的应用效果,并分析误诊原因。结果诊断准确率腹部超声为65.74%,经阴道超声为78.70%,联合诊断为88.89%,差异均有统计学意义(P<0.05)。结论超声检查对妇科急腹症的诊断较准确,但在临床工作中,不可单一观察声像图,需注意患者的月经史、有无阴道流血、后穹窿穿刺结果及人绒毛膜促性腺激素检测情况,以免误诊。

Objective To explore the diagnositic value of ultrasound in gynecological acute abdomen. Methods 108 patients with gynecological acute abdomen in the People＇s Hospital of Sanya from February 2014 to February 2015 were selected and examined by abdominal ultrasound and transvaginal ultrasound and later confirmed by operations or clinicians. Judged application effect of the two kinds of examination and joint examination. Results The accuracy rate of abdominal ultrasound was 65.74 % ; the accuracy rate of transvaginal ultrasound was 78.70 % ;the accuracy rate of joint examination was 88.89 %. The differences were significant statistically （P 〈 0. 05 ）. Conclusion Ultrasound is an appropriate diagnositie method of gynecologic acute abdomen, but in clinical we need to pay attention to the patient＇s menstrual history, the euldoeentesis and HCG results, in order to avoid misdiagnosis.