经阴道与腹部超声诊断宫角妊娠的临床价值

目的：比较经阴道超声与经腹部超声检查对宫角妊娠的诊断价值。方法将我院妇产科2015年5月至2016年5月期间收治的80例疑为宫角妊娠的患者作为研究对象，所有患者均先行经腹部超声检查，再行经阴道超声检查，以病理诊断结果为金标准，比较两种检查方式对宫角妊娠的诊断准确率，总结宫角妊娠的超声特征。结果经腹部超声诊断对宫角妊娠的诊断敏感性为61.33%、特异性为20.00%、阳性预测值为92.00%、阴性预测值为3.33%、准确率为58.75%；经阴道超声对宫角妊娠的诊断敏感性为82.67%、特异性为80.00%、阳性预测值为98.41%、阴性预测值为23.53%、准确率为82.50%。经阴道超声检查对宫角妊娠的诊断准确性、敏感性、特异性、阴性预测值均明显高于经腹部超声检查，差异均有统计学意义(P<0.05)。经腹部超声与经阴道超声联合诊断宫角妊娠的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为90.00%、90.67%、80.00%、98.55%、36.36%。结论与腹部超声检查比较，经阴道超声检查对宫角妊娠的诊断准确率更高，并且二者联用能够有效提高宫角妊娠的诊断敏感性与准确性，能够为临床早期诊断、处理宫角妊娠提供有效依据。

Clinical value of transvaginal ultrasound and abdominal ultrasound in diagnosis of uterine horn pregnancy

Objective To compare the diagnostic value of transvaginal ultrasound and abdominal ultrasound in the diagnosis of uterine horn pregnancy. Methods Eighty patients with uterine horn pregnancy in our hospital from May 2015 to May 2016 were selected as research objects. All patients were first examined by abdominal ultrasound, and then underwent transvaginal ultrasound. The diagnostic accuracy of the two types of tests were compared with the results of pathological diagnosis (as the gold standard). Ultrasound features of uterine horn pregnancy were summarized. Results The diagnostic sensitivity of abdominal ultrasound in diagnosis of uterine horn pregnancy was 61.33%, with the specificity of 20.00%, positive predictive value of 92.00%, negative predictive value of 3.33%, accuracy rate of 58.75%. The diagnostic sensitivity of transvaginal ultrasound on uterine horn pregnancy was 82.67%, with the specifici-ty of 80.00%, positive predictive value of 98.41%, negative predictive value of 23.53%, accuracy of 82.50%. The diag-nostic accuracy, sensitivity, specificity and negative predictive value of transvaginal ultrasound in the diagnosis of uter-ine horn pregnancy were significantly higher than those of the abdominal ultrasound, and the differences were statistical-ly significant (P<0.05). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasound combined with abdominal ultrasound in diagnosis of uterine horn pregnancy were 90.00%, 90.67%, 80.00%, 98.55%, 36.36%, respectively. Conclusion Compared with abdominal ultrasound, transvaginal ultra-sound in the diagnosis of cornual pregnancy has higher accuracy. Combination of the both can effectively improve the di-agnostic sensitivity and accuracy of the uterine horn pregnancy, and can provide an effective basis for early diagnosis and treatment of uterine horn pregnancy.