羊水监测护垫法快速诊断胎膜早破的可行性分析研究

Feasibility of Rapid Diagnosis of Premature Rupture of Membranes with Amniotic Fluid Monitoring Pad

目的探讨羊水监测护垫法(护垫法)快速诊断胎膜早破(PROM)的临床可行性。方法选取2016年6—12月江西省人民医院妇产科收治的符合纳入标准的孕妇90例为研究对象,按纳入标准的不同分为A组(确诊PROM)、B组(疑似PROM)、C组(无PROM)各30例。孕妇均使用护垫法、阴道分泌物进行直接涂片查找羊齿状结晶检测法(结晶法)、p H试纸检测法(p H法)、胰岛素样生长因子结合蛋白-1定量检测法(IGFBP-1法)诊断PROM,比较各检测方法的灵敏度、特异度、Youden指数、阳性预测值、阴性预测值。结果护垫法诊断PROM的灵敏度、特异度、Youden指数、阳性预测值、阴性预测值高于结晶法、p H法(P<0.05)。结论护垫法诊断PROM具有简便易行、特异性好、灵敏度高、价格低廉、可家居使用的优点,在临床快速诊断PROM方面有一定的可行性。

Objective To evaluate the clinical feasibility of rapid diagnosis of premature rupture of membranes（PROM） using amniotic fluid monitoring pad（pad method）.Methods We enrolled 90 pregnant women who received treatment in Department of Obstetrics and Gynecology,Jiangxi Provincial People＇s Hospital during June to December 2016 and divided them into group A（confirmed PROM,n=30）,group B（suspected PROM,n=30） and group C（intact fetal membranes,n=30） based on the clinical manifestations and results of speculum examination.Pad method,amniotic fluid crystallization test（crystallization test）,and p H determination using p H paper（p H method）,and human IGFBP-1 ELISA kit（IGFBP-1 method） were all used to diagnose PROM in all cases.The sensitivity,specificity,Youden index,positive and negative predictive values of the four methods were analyzed comparatively.Results Concretely,the sensitivity,specificity,Youden index,positive and negative predictive values of the pad method were all higher compared with both the crystallization test and p H method（P〈0.05）.Conclusion Pad method is feasible for clinical rapid diagnosis of PROM because it is simple to use（even can be used at home）,owns good specificity and sensitivity,and is inexpensive.