异位妊娠腹腔镜镜像与TVS表现及血清β-HCG表达的相关性研究

Correlation Research between Laparoscopic Mirror Image of Ectopic Pregnancy and TVS Expression and Serum β-HCG Expression

目的通过分析异位妊娠腹腔镜镜像与经阴道超声(TVS)表现及血清β-HCG的关系,探讨其之间的关联性。方法本文采用回顾性研究,收集从2018年1月~12月广西中医药大学附属瑞康医院妇科收治住院的106例异位妊娠患者,术前常规行血清β-HCG测定及TVS诊断,并经腹腔镜手术证实,分析其镜像特征。结果106例腹腔镜手术均成功,无一例中转开腹,腹腔镜下诊断为异位妊娠103例,并经病理确诊,腹腔镜诊断符合率为100.00%。术前最后一次阴道超声诊断符合率为97.17%,不符合者假阳性3例,误诊率2.83%,血清β-HCG表达与异位妊娠囊胚的大小、表面张力及血管扩张程度显著相关性(P<0.01),与子宫内膜厚度、包块内部及周围可见血流信号及与囊胚内可见卵黄囊、胚芽、心管搏动等影像学征之间存在相关关系(P<0.05),而与盆腔积液无关(P>0.05)。结论异位妊娠腹腔镜镜像与TVS表现及血清β-HCG存在内在的联系与规律性,这些规律为揭开异位妊娠发展机制和指导临床治疗提供理论支持,以提高异位妊娠的诊断率。

Objective To investigate the relationship between laparoscopic mirror image of ectopic pregnancy and transvaginal ultrasound (TVS) and serum β-HCG. Methods A retrospective study was conducted to collect 106 patients with ectopic pregnancy admitted to the Department of Gynecology, Ruikang Hospital, Guangxi University of Traditional Chinese Medicine from January to December 2018. Preoperative routine serum β-HCG and TVS diagnosis were performed. Laparoscopic surgery confirmed the analysis of its mirror features. Results 106 cases of laparoscopic surgery were successful. No cases were converted to open surgery. 103 cases of ectopic pregnancy were diagnosed by laparoscopy and confirmed by pathology. The coincidence rate of laparoscopic diagnosis was 100.00%. The coincidence rate of the last vaginal ultrasound diagnosis before surgery was 97.17%, 3 cases of non-conformity were false positive, the misdiagnosis rate was 2.83%, and the expression of serum β-HCG was significantly correlated with the size, surface tension and degree of vasodilation of ectopic blastocysts(P<0.01), there was a correlation between the endometrial thickness, the blood flow signal inside and around the mass, and the imaging signs such as yolk sac, embryo and cardiac tube pulsation in the blastocyst (P<0.05). The pelvic fluid was irrelevant (P>0.05). Conclusion There is an intrinsic connection and regularity between laparoscopic mirror image of ectopic pregnancy and TVS performance and serum β-HCG. These rules provide theoretical support for uncovering the development mechanism of ectopic pregnancy and guiding clinical treatment to improve the diagnosis rate of ectopic pregnancy.