超声及降钙素原在妇科急腹症鉴别诊断中的应用

Ultrasound and procalcitonin in differential diagnosis of gynecologic acute abdomen

目的探讨超声及降钙素原(PCT)在妇科急腹症鉴别诊断中的应用。方法回顾性分析2013年10月-2015年11月苏州大学附属第三医院妇科收治的急腹症患者40例,按病因分为感染组(30例)和肿瘤并发症组(10例)。比较两组的PCT、其他炎性指标及肿瘤指标,评价PCT对感染性急腹症的诊断价值;比较超声、炎性指标及肿瘤指标对两组妇科急腹症的诊断效能。结果两组妇科急腹症的炎性指标中,仅感染组的PCT大于肿瘤并发症组;当PCT界值为0.061 ng/ml时,诊断敏感性和特异性均较高;肿瘤指标中,仅肿瘤并发症组的鳞状细胞癌相关抗原高于感染组;超声对肿瘤并发症急腹症有更高的准确率,超声联合PCT可提高感染性急腹症的诊断准确率。结论 PCT用于感染性急腹症的诊断价值优于其他炎性指标,超声联合PCT有助于妇科急腹症的鉴别诊断。

Objective To investigate the differential diagnosis of ultrasound and procalcitonin in gynecological acute abdomen. Methods A retrospective analysis of 40 patients with gynecological acute abdomen admitted to our hospital from October 2013 to November 2015 was performed. According to the cause of disease, all patients were divided into infectious diseases group （30 cases） and tumor complications group （10 cases）. PCT, other inflammatory markers and tumor index of two groups were compared, and then evaluated the value of PCT diagnosis of infection of acute abdomen. The diagnostic efficacy of ultrasound, inflammation and tumor index of two types of gynecological acute abdomen were compared. Results In the inflammatory indexes of two groups of gynecologic acute abdomen, only PCT of infected group was significantly higher than that of tumor complications group. The diagnostic sensitivity and specificity were higher when the PCT cutoff value was 0.061 ng/ml. Among the tumor markers, SCC of tumor complications group was significantly higher than that in the infection group. Ultrasound in tumor complications group had higher accuracy and uhrasound combined with PCT significantly improved the accuracy of diagnosis of infectious diseases group. Conclusions Diagnostic value of PCT for infectious acute abdomen is superior to that of other inflammatory markers, and ultrasound combined with the PCT is helpful in the differential diagnosis of gynecologic acute abdomen.