妇科急腹症诊断中经腹部超声联合经阴道超声的价值研究

Study on tvalue of TAS combined with TVS in diagnosis of gynecological acute abdomen

目的 探讨经腹部超声(TAS)联合经阴道超声(TVS)在妇科急腹症诊断中的临床应用价值。方法 选取2019年1月—2021年1月平煤神马医疗集团总医院收治的80例疑似妇科急腹症患者进行研究,均采用单一TAS、TVS和TAS联合TVS对其进行检查,最后以手术病理检查结果为诊断金标准,对比分析三种检查方法的诊断效能(敏感性、特异性、漏诊率、误诊率、阳性预测值、阴性预测值、诊断准确率)及不同急腹症检出率。结果 病理检查结果显示,80例患者中,阳性65例,阴性15例。与单一TAS、TVS检查比较,TAS联合TVS的敏感性、特异性及诊断准确率明显增高;TAS联合TVS的误诊率、漏诊率明显低于TAS、TVS检查,阳性预测值、阴性预测值明显高于TAS、TVS检查,差异具有统计学意义(P<0.05)。病理检查结果显示,80例患者中,异位妊娠患者共18例,急性盆腔炎患者共40例,卵巢囊肿蒂扭转患者共12例,卵巢囊肿破裂患者共10例。TAS联合TVS的异位妊娠、卵巢囊肿蒂扭转及总检出率明显高于TAS、TVS检查,差异具有统计学意义(P<0.05)。结论 采用TAS联合TVS对妇科急腹症患者进行检查,其灵敏度和特异度较高,一定程度上降低了误诊或漏诊的几率,有助于进一步提高患者的诊断准确率,同时还能及时明确患者的疾病类型。

Objective To investigate the clinical value of transabdominal ultrasound(TAS) combined with transvaginal ultrasound(TVS) in the diagnosis of gynecological acute abdomen.Methods Eighty patients with suspected gynecological acute abdomen who received treatment in our hospital from January 2019 to January 2021 were selected for the study.All of them were examined by single TAS,TVS and TAS combined TVS,with pathological examination results as the gold standard for diagnosis.The diagnostic efficiency(sensitivity, specificity, missed diagnosis rate, misdiagnosis rate, positive predictive value, negative predictive value, diagnostic accuracy rate) and the detection rate of different acute abdomen were compared and analyzed.Results Pathological examination showed that 65 of the 80 patients were positive and 15 were negative.Compared with single TAS and TVS,the sensitivity, specificity and diagnostic accuracy of TAS combined WITH TVS were significantly higher.The misdiagnosis rate and missed diagnosis rate of TAS combined WITH TVS were significantly lower than those of TAS and TVS,and the positive predictive value and negative predictive value were significantly higher than those of TAS and TVS,with statistical significance(P<0.05).Pathological examination results showed that among the 80 patients, there were 18 ectopic pregnancy patients, 40 salpingitis patients, 12 ovarian cyst pedicle torsion patients, and 10 ovarian cyst rupture patients.The total detection rates of ectopic pregnancy, torsion of ovarian cyst pedicle and TAS combined with TVS were significantly higher than those of TAS and TVS,and the differences were statistically significant(P<0.05).Conclusion TAS combined with TVS has high sensitivity and specificity in the examination of patients with gynecological acute abdomen, which can reduce the probability of misdiagnosis or missed diagnosis to a certain extent, help to further improve the diagnostic accuracy of patients, and also timely identify the disease type of patients.