经阴道超声与经腹部超声诊断剖宫产切口部妊娠的临床研究

The Clinical Research of Transvaginal Ultrasound and Transabdominal Ultrasound in the Diagnosis of CSP

目的:探讨经阴道超声与经腹部超声诊断剖宫产切口部妊娠(CSP)的诊断价值。方法:选择2016年4月~2019年4月朝阳市中心医院妇科收治的可疑CSP患者98例,对患者进行经阴道超声及经腹部超声检查,比较两种检查方法诊断CSP的准确度、灵敏度与特异度及对比较经阴道超声与经腹部超声诊断CSP不同类型的超声诊断符合率。结果:经阴道超声组诊断的CSP的准确度为90.4%,灵敏度为92.1%,特异度为67.5%,经腹部超声组诊断CSP的准确度为72.9%,灵敏度为83.4%,特异度为45.1%,两组差异相比具有统计学意义(P<0.05)。经阴道超声诊断CSP妊娠囊完全突入型的符合率为100%,诊断CSP妊娠囊部分突入型的符合率为92.81%,诊断CSP混合团块型的符合率为97.22%,经腹部超声诊断CSP妊娠囊完全突入型的符合率为80.00%,诊断CSP妊娠囊部分突入型的符合率为73.80%,诊断CSP混合团块型的符合率为77.77%,两组相比差异具有统计学意义(P<0.05)。结论:经阴道超声诊断对CSP的诊断效能较高,能准确判断孕囊的位置及类型,为临床医师提供准确的信息,提供个体化的治疗依据,具有重要的参考价值。

Objective:To investigate the diagnostic value of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of cesarean incision pregnancy(CSP).Methods:98 patients with suspected CSP treated in the Department of Gynecology of Chaoyang Central Hospital from April 2016 to April 2019 were examined by transvaginal ultrasound and transabdominal ultrasound.The accuracy,sensitivity and specificity of the two methods in the diagnosis of CSP were compared,and the coincidence rates of transvaginal ultrasound and transabdominal ultrasound in the diagnosis of different types of CSP were compared.Results:The accuracy,sensitivity and specificity of CSP in transvaginal ultrasound group were 90.4%,92.1%and 67.5%,respectively;The accuracy,sensitivity and specificity of transabdominal ultrasound in the diagnosis of CSP were 72.9%,83.4%and 45.1%,respectively.There was significant difference between the two groups(P<0.05).The coincidence rate of transvaginal ultrasound in the diagnosis of CSP pregnancy sac completely protruding type was 100%,that of CSP pregnancy sac partially protruding type was 92.81%,and that of CSP mixed mass type was 97.22%;The coincidence rate of abdominal ultrasound in the diagnosis of CSP pregnancy sac completely protruding type was 80.00%,that of CSP pregnancy sac partially protruding type was 73.80%,and that of CSP mixed mass type was 77.77%.There was significant difference between the two groups(P<0.05).Conclusion:Transvaginal ultrasonography has high diagnostic efficiency for CSP,can accurately determine the location and type of gestational sac,provide accurate information for clinicians,and provide individualized treatment basis,which has important reference value.