经阴道彩超在卵巢黄体破裂和宫外孕破裂鉴别诊断中的应用

Application of Transvaginal Color Doppler Ultrasound in the Differential Diagnosis of Ruptured Corpus Luteum and Ectopic Pregnancy

目的:分析卵巢黄体破裂、宫外孕破裂疾病特点,评价经阴道彩超的鉴别诊断价值。方法:选择2019年8月~2020年8月本院妇科收治的卵巢黄体破裂、宫外孕破裂患者各60例,分别作为观察1组、观察2组。均经阴道彩超诊断,获得医院伦理委员会批准,比较彩色血流变化特征、血流频谱变化特征、血流动力学参数情况。结果:组间彩色血流变化特征比较,观察1组环状与半环状占比率高于观察2组(P<0.05),点状、条状占比率均低于观察2组(P<0.05);血流频谱变化特征比较,观察1组的低阻力型、占比率高于观察2组(P<0.05),超低阻力型、高阻力型、无张力期血流频谱、舒张期血流频谱占比率均低于观察2组(P<0.05);血流动力学参数结果方面,观察1组患者的血流阻力指数(Resistance Index,RI)以及脉搏指数(perfusion index,PI)均低于观察2组(P<0.05),收缩期峰值流速(peak systolic velocity,PSV)高于观察2组(P<0.05)。结论:经阴道彩超用于鉴别诊断卵巢黄体破裂、宫外孕破裂彩色血流信号变化特征明显,诊断价值理想。

Objective:To analyze the characteristics of ruptured corpus luteum of the ovary and ruptured ectopic pregnancy,and evaluate the differential diagnosis value of transvaginal color Doppler ultrasound.Methods:The 60 patients with ruptured ovarian corpus luteum and ruptured ectopic pregnancy who were admitted to the Department of Gynecology in our hospital from August 2019 to August 2020 were selected as observation group 1 and observation group 2.All were diagnosed by vaginal color Doppler ultrasound,approved by the hospital ethics committee,and compared the characteristics of color blood flow changes,blood flow spectrum changes,and hemodynamic parameters.Results:Comparison of the characteristics of color blood flow changes between groups.The proportion of circular and semicircular in observation group 1 was higher than that in observation group 2(P<0.05),and the proportions of dots and bars were lower than observation group 2(P<0.05);Comparison of the characteristics of blood flow spectrum changes,observation group 1 has a lower resistance type and a higher proportion than observation group 2(P<0.05),ultra-low resistance type,high resistance type,tension-free blood flow spectrum,and diastolic blood flow The frequency spectrum ratio was lower than that of the observation group 2(P<0.05);In terms of hemodynamic parameter results,the blood flow resistance index(RI)and pulse index(perfusion index,PI)were lower than the observation group 2(P<0.05),and the peak systolic velocity(PSV)during the systole was higher than the observation group 2(P<0.05).Conclusion:Transvaginal color Doppler ultrasound is used for differential diagnosis of ruptured ovarian corpus luteum and ectopic pregnancy.The color blood flow signal changes have obvious characteristics,and the diagnostic value is ideal.