经阴道和腹部彩色多普勒超声对子宫切口妊娠的诊断价值比较

Comparison of the value of transvaginal and transabdominal color Doppler ultrasound in the diagnosis of uterine incision pregnancy

目的:对比经阴道和腹部彩色多普勒超声对子宫切口妊娠的诊断价值。方法:选取2011年3月至2016年3月陕西省延安市中医医院收治的70例疑似子宫切口妊娠患者。按随机数字表法将70例患者分为对照组(37例,其中子宫切口妊娠患者28例)和观察组(33例,其中子宫切口妊娠患者30例)。对照组采用经腹部彩色多普勒超声检查,观察组采用经阴道彩色多普勒超声检查。与病理结果比较,分析经腹部与经阴道彩色多普勒超声两种诊断方式对子宫切口妊娠的符合率、灵敏度和特异度。结果:观察组的诊断符合率(90.0%)、灵敏度(93.3%)和特异度(66.7%)均明显高于对照组的73.0%、82.1%和44.4%(均P<0.05)。两组超声分型的诊断符合率相比差异无统计学意义(P>0.05),但观察组对早孕型和胚囊型的诊断符合率略高于对照组。结论:经阴道彩色多普勒超声检查具有较高的诊断符合率、灵敏度和特异度,对子宫内部的动态观察优势明显,值得临床推广使用。

Objective：To compare the value of transvaginal color Doppler ultrasound（TVCDU）and transabdominal color Doppler ultrasound（TACDU）in the diagnosis of uterine incision pregnancy.Methods：70 patients with suspected uterine incision pregnancy in our hospital from March 2011 to March 2016 were selected and randomly divided into a control group（37 cases,in which 28 women underwent uterine incision pregnancy）,and an observation group（33 cases,in which 30 women underwent uterine incision pregnancy）.The patients in the observation group were given TVCDU detection,while those in the control group were given TACDU detection.The results of ultrasonic diagnosis were compared with pathological examination.Results：TVCDU detection showed a diagnostic coincidence rate of 90.0%,sensitivity of 93.3%,specificity of 66.7%,and TACDU was respectively 73.0%,82.1% and 44.4%（P〈0.05）.There was no significant difference in the accordance rates of different types of ultrasonography between the two groups（P〉0.05）,but the coincidence rates of early pregnancy and embryo sac were slightly higher in the observation group than those in the control group.Conclusion：TVCDU was more valuable in the diagnosis of uterine incision pregnancy with higher coincidence rate,sensitivity and specificity,and was more effective way to detect dynamic changes inside uterus.