子宫动脉PI及妊娠黄体超声诊断输卵管妊娠价值及危险因素分析

Diagnostic value of the pulsatility index value and the situation of corpora luteum graviditatis examined by ultrasound for tubal ectopic pregnancy and analysis of the risk factors

目的:探究超声检测子宫动脉PI变化及妊娠黄体超声对输卵管妊娠的诊断价值及危险因素。方法:将2017年2月-2022年1月于本院诊断为输卵管妊娠的101例患者纳入为观察组,产前检查正常孕妇100例为对照组。比较两组超声检查子宫动脉阻力指数(RI)、搏动指数(PI)、收缩期峰值流速(PSV)、舒张末期流速(EDV),比较观察组妊娠黄体与输卵管同侧和不同侧、功能侧和非功能侧患者的PI,分析子宫动脉PI、妊娠黄体及输卵管PI变化值诊断输卵管妊娠价值,分析输卵管妊娠危险因素。结果:观察组RI和PI均低于对照组,PSV和EDV均高于对照组;同侧组子宫动脉PI水平(4.19±1.11)低于非同侧组(19.74±5.29),功能侧组子宫动脉PI水平(2.62±0.19)低于非功能侧组(2.77±0.25)(均)。ROC曲线分析,子宫动脉PI、妊娠黄体与输卵管PI变化值联合诊断可提高输卵管妊娠诊断效能,临界值子宫动脉PI≤2.22,妊娠黄体与输卵管PI变化值≥0.18;输卵管炎、孕产≥3次、放置宫内节育器均是输卵管妊娠危险因素。结论:超声检测子宫动脉PI变化及妊娠黄体超声对输卵管妊娠有较好的诊断价值,输卵管炎、孕产≥3次及放置宫内节育器者建议作为临床疑似异位妊娠的重点关注对象。

Objective:To study the diagnostic value of the pulsatility index(PD)value and the corpora luteum graviditatis situation examined by ultrasound for tubal ectopic pregnancy of women,and to analyze the risk factors of tubal ectopic pregnancy of the women.Methods:101 women with tubal ectopic pregnancy diagnosed and treated in hospital were selected in research group from February 2017 to January 2022.100 cases of intrauterine pregnancy were selected in control group during the same period.The values of uterine artery resistance index(RI),PI,peak systolic velocity(PSV),and end diastolic velocity(EDV)examined by ultrasound of the women were compared between the two groups.The situation of corpora luteum graviditatis of the women in the research group were compared between the same side of the fallopian tube and the different side of the fllopian tube,and between the fllopian tube with function and the fallopian tube without function.The values of the PI values of uterine artery and fallopian tube,and the situation of corpus luteum graviditatis of the women for diagnosing their tubal ectopic pregnancy was analyzed,and the risk factors of ectopic tubal pregnancy were also analyzed.Results:The values of RI and PI of the women in the research group were significantly lower than those of the women in the control group,while the values of PSV and EDV of the women in the research group were significantly higher than those of the women in the control group.The uterine artery PI value in the same side of the fllopian tube of the ectopic pregnancy(4.19±1.11)of the women in the research group was significantly lower than that(19.74±5.29)in the different side of the fallopian tube,and which(2.62±0.19)in the fallopian tube with function of the women in the research group was significantly lower than that(2.77±0.25)in the fallopian tube without function(all P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the combined values of uterine artery and fallopian tube PI,and the situation of corpora luteum graviditatis of the women could improve their diagnostic efficiency for tubal ectopic pregnancy.The critical value of the uterine artery PI value≤2.22,and the changes of the values of the corpora luteum graviditatis,and the value of tubal PI≥0.18,the salpingitis,the pregnancy≥3 times,and the intrauterine device(IUD)inserted were all the risk factors of tubal ectopic pregnancy.Conclusion:The changes of the uterine artery PI value and the situation of corpora luteum graviditatis examined by ultrasound have higher diagnostic value for tubal ectopic pregnancy.The women with salpingitis,pregnancy≥3 times,or IUD inserted should be as the focus of attentional objects.