分析经阴道彩色多普勒超声对诊断异位妊娠的临床意义

Analysis of the Clinical Significance of Transvaginal Color Doppler Ultrasound in the Diagnosis of Ectopic Pregnancy

目的:探究经阴道彩色多普勒超声(TVCDS)对诊断异位妊娠的临床意义。方法:选择2018年6月—2020年4月郑州人民医院收治的疑似异位妊娠患者80例为临床观察对象,所有患者均行TVCDS及经腹部彩色多普勒超声(TACDS)检查。以手术病理结果作为诊断异位妊娠的“金标准”,分析手术病理结果、TVCDS与TACDS诊断价值及一致性,比较两种检查方法下异位妊娠典型声像图特征。结果:经手术病理共明确异位妊娠患者67例,检出率为83.75%。TVCDS检查共检出异位妊娠患者65例,检出率为81.25%。TACDS检查共检出异位妊娠患者59例,检出率为73.75%。在异位妊娠诊断中,TVCDS检查灵敏度、准确度均高于TACDS检查,差异有统计学意义(χ^(2)=5.457、7.059,P<0.05),两种检查在特异度比较中,差异无统计学意义(χ^(2)=0.0782,P>0.05)。kappa检验显示:TVCDS与手术病理结果的一致性尚可,差异有统计学意义(kappa=0.741,P=0)。TACDS与手术病理结果的一致性不佳,差异有统计学意义(kappa=0.338,P=0.002)。TVCDS在子宫内假孕囊、附件包块、盆腔积液、外孕囊影中可见胚芽及胎心等征象中检出率高于TACDS,差异有统计学意义(χ^(2)=19.608、9.001、23.333、53.740,P<0.05)。结论:采用TVCDS检查诊断异位妊娠具有较高的临床应用价值,为临床诊断提供影像学参考,以提高诊断符合率。

Objective:To explore the clinical significance of transvaginal color Doppler ultrasound(TVCDS)in the diagnosis of ectopic pregnancy.Methods:80 patients with suspected ectopic pregnancy in the hospital from June 2018 to April 2020 were selected.All patients underwent TVCDS and transabdominal color Doppler ultrasound(TACDS)examination.The results of surgical pathology were used as the“gold standard”for the diagnosis of ectopic pregnancy.The diagnostic value and consistency of surgical pathological results,TVCDS and TACDS were analyzed.Results:67 cases of ectopic pregnancy were confirmed by operation and pathology,the detection rate was 83.75%.65 cases of ectopic pregnancy were detected by TVCDS,the detection rate was 81.25%.59 cases of ectopic pregnancy were detected by TACDS,the detection rate was 73.75%.The sensitivity and accuracy of TVCDS in the diagnosis of ectopic pregnancy were higher than those of TACDS(χ^(2)=5.457,7.059,P<0.05).There was no statistically significant difference in the spccificity of the two tests.Kappa test showed that the consistency of TVCDS and surgical pathology was acceptable(kappa=0.741,P=0).The results of TACDS and surgical pathology were better than those of TVCDS(kappa=0.741,P=0).The detection rate of TVCDS was higher than that of TACDS in the false gestational sac,adnexal mass,pelvic effusion,embryo and fetal heart in the ectopic gestational sac,the difference was statistically significant(χ^(2)=19.608,9.001,23.333,53.740,P<0.05).Conclusion:TVCDS has high clinical application value in the diagnosis of ectopic pregnancy,which can provide imaging reference for clinical diagnosis and improve the diagnostic coincidence rate.