阴道超声(TVS)和经腹超声(TAS)在异位妊娠早期诊断中的应用价值

Application Value of Transvaginal Ultrasound(TVS)and Transabdominal Ultrasound(TAS)in the Early Diagnosis of Ectopic Pregnancy

目的:探究阴道超声(TVS)和经腹超声(TAS)在异位妊娠早期诊断中的应用价值。方法:选择2017年10月~2020年10月于某院住院治疗的经临床症状、血清人类绒毛膜促性腺激素检查疑似异位妊娠患者80例作为研究对象,所有患者均于手术探查前行TVS和TAS检查。以手术探查或病理诊断结果为金标准,分别计算单纯TVS检查、单纯TAS检查及二者联合诊断异位妊娠的灵敏度、特异度及准确度。结果:80例疑似异位妊娠患者中,经手术探查或病理检查,共64例患者确诊为异位妊娠,其中输卵管妊娠59例,卵巢妊娠1例,宫角妊娠2例,宫颈部妊娠1例,间质部妊娠1例。以手术探查或病理检查为金标准,TAS诊断异位妊娠的灵敏度为92.19%(59/64),特异度为81.25%(13/16),准确度为90.00%(72/80);TVS诊断异位妊娠的灵敏度为96.87%(62/64),特异度为87.50%(14/16),准确度为95.00%(76/80);二者联合诊断异位妊娠的灵敏度为100.00%(64/64),特异度为93.75%(15/16),准确度为98.75%(79/80)。结论:TAS联合TVS提高了异位妊娠患者的诊断的灵敏度、特异度和准确率,采用二者联合诊断,能够降低临床漏诊率,降低因此导致的异位妊娠不良事件。

Objective:To explore the application value of transvaginal ultrasound(TVS)and transabdominal ultrasound(TAS)in the early diagnosis of ectopic pregnancy.Methods:From October 2017 to October 2020,80 patients with suspected ectopic pregnancy by clinical symptoms and serum hCG examination in a hospital were selected as the research objects,and all patients were examined by TVS and TAS before surgical exploration.The sensitivity,specificity,and accuracy of TVS alone,TAS alone and joint diagnosis of ectopic pregnancy were calculated,respectively,using surgical exploration or pathological diagnosis results as the gold standard.Results:Among 80 cases of suspected ectopic pregnancy,64 cases were diagnosed as ectopic pregnancy by surgical exploration or pathological examination,including 59 cases of tubal pregnancy,1 case of ovarian pregnancy,2 cases of cornual pregnancy,1 case of cervical pregnancy and 1 case of interstitial pregnancy.Using surgical exploration or pathological diagnosis results as the gold standard,the sensitivity,specificity and accuracy of TAS in the diagnosis of ectopic pregnancy were 92.19%(59/64),81.25%(13/16)and 90.00%(72/80),respectively.The sensitivity,specificity and accuracy of TVS in the diagnosis of ectopic pregnancy were 96.87%(62/64),87.50%(14/16)and 95.00%(76/80),respectively.The sensitivity,specificity and accuracy of TAS combined with TVS in the diagnosis of ectopic pregnancy were 100.00%(64/64),93.75%(15/16),and 98.75%(79/80)respectively.Conclusion:TAS combined with TVS can improve the sensitivity,specificity and accuracy in the diagnosis of ectopic pregnancy.The combination of TAS and TVS can reduce the clinical missed diagnosis rate and the adverse events of ectopic pregnancy.