经腹和经阴道超声在鉴别诊断异位妊娠与卵巢黄体破裂中的疗效探讨

Therapeutic Effect of Transabdominal and Transvaginal Ultrasound in Differential Diagnosis of Ectopic Pregnancy and Rupture of Corpus Luteum

目的研究经腹和经阴道超声在鉴别诊断异位妊娠与卵巢黄体破裂中的价值,为临床诊断工作的开展提供有价值的参考依据。方法将2015年6月—2019年6月该院40例疑似异位妊娠与卵巢黄体破裂患者作为主要研究对象,经腹部超声检查后进行阴道超声检查,对患者子宫内膜、盆腔积液与附件包块状况进行深入观察,对比腹部超声诊断结果与手术病理结果、阴道超声诊断结果与手术病理结果。结果经手术病理检查后,40例患者中30例为异位妊娠,9例为卵巢黄体破裂,剩余1例。腹部超声诊断结果与手术病理结果对比后,前者异位妊娠检出率50.0%、卵巢黄体破裂检出率5.0%,前者吻合率明显比后者低,差异有统计学意义﹙χ^2=5.333、5.165,P=0.021、0.023<0.05﹚。阴道超声诊断结果与手术病理结果对比后,前者异位妊娠检出率72.5%、卵巢黄体破裂检出率20.0%,差异无统计学意义﹙χ^2=0.065、0.075,P=0.799、0.785>0.05﹚。血流参数的RI水平与PI水平,较之于卵巢黄体破裂,异位妊娠明显更高,分别为(0.54±0.12)、(0.93±0.24),差异有统计学意义﹙t=3.145、2.528,P=0.003、0.016<0.05﹚。结论临床鉴别异位妊娠与卵巢黄体破裂的过程中,经阴道超声的检测准确率更高,可不断增强临床鉴别与诊断准确程度。具有较高的临床推广与应用价值。

Objective To study the value of transabdominal and transvaginal ultrasound in the differential diagnosis of ectopic pregnancy and corpus luteum rupture,and provide a valuable reference for clinical diagnosis.Methods From June 2015 to June 2019,40 patients with suspected ectopic pregnancy and ovarian corpus luteum rupture in the hospital were the main subjects.After abdominal ultrasound examination,vaginal ultrasonography was performed on the endometrium and pelvic fluid of patients.The condition of the accessory mass was observed in depth,and the results of abdominal ultrasound diagnosis and surgical pathology,vaginal ultrasound diagnosis and surgical pathological results were compared.Results After surgical pathological examination,30 cases of 40 patients were ectopic pregnancy,9 caseswere ruptured ovarian corpus luteum,and the remaining 1 case.After comparing the results of abdominal ultrasound diagnosis with surgical pathology,the former ectopic pregnancy detection rate was 50.0%,and the ovarian corpus luteum rupture detection rate was 5.0%.The former agreement rate was significantly lower than the latter,the difference was statistically significant(χ^2=5.333,5.165,P=0.021,0.023<0.05).After comparing the results of vaginal ultrasound diagnosis with surgical pathology,the former ectopic pregnancy detection rate was 72.5%,ovarian corpus luteum rupture detection rate was 20.0%,the difference was not statistically significant(χ^2=0.065,0.075,P=0.799,0.785>0.05).The RI level and PI level of blood flow parameters were significantly higher than ovarian corpus luteum rupture,which were(0.54±0.12)and(0.93±0.24),the difference was statistically significant(t=3.145,2.528,P=0.003,0.016<0.05).Conclusion In the process of clinical identification of ectopic pregnancy and corpus luteum rupture,the accuracy of transvaginal ultrasound detection is higher,which can continuously enhance the accuracy of clinical identification and diagnosis.It has high clinical promotion and application value.