阴道超声在妇科急症异位妊娠诊断中的应用价值

目的:探讨阴道超声(Transvaginal ultrasonography,TVS)在异位妊娠患者诊断中的应用价值。方法:选择2008年2月～2010年11月收治的89例经开腹或腹腔镜手术证实为异位妊娠的患者为研究对象,对妇科急腹症经阴道二维超声及结合彩色多谱勒超声的声像资料进行回顾性分析,并对腹部超声法(Transabdominal sonography,TAS)及阴道超声法的检查结果进行对比。结果:本组89例妇科急腹症经开腹或腹腔镜手术证实为异位妊娠,经阴道超声TVS检测诊断异位妊娠85例,诊断符合率为95.5%,其中胎囊型31/85(34.8%);包块型52/85(58.4%);盆腔积液型2/85(2.2%)。经腹超声TAS检测诊断异位妊娠62例,与手术病理对照符合率为69.7%;其中胎囊型18/62(20.2%);包块型36/62(40.4%);盆腔积液型8/62(9.0%)。二者相比较差异有统计学意义(P<0.05)。结论:经阴道超声检查能较早诊断妇科急症异位妊娠,并具备阳性率高、分辨力较高,能清晰显示盆腔脏器的细微病变等显著优势,可以为诊断妇科急症异位妊娠提供技术基础。

Application value of transvaginal ultrasound in gynecological diagnosis of emergency ectopic pregnancy

Objective: To explore application value of transvaginal ultrasound(TVS) in gynecological diagnosis of emergency ectopic pregnancy.Methods: A total of 89 cases with ectopic pregnancy confirmed by opening surgery or laparoscopic operation,who were admitted from February 2008 to November 2010 were selected.Their data about transvaginal color Doppler ultrasonography and ultrasound of the audio-visual data were retrospectively analyzed,and abdominal ultrasound(TAS) and TVS examination results were compared.Results:A total of 85 cases were detected by TVS(95.5%),including sac-type 31/85(34.8%),mass-type 52/85(58.4%),pelvic fluid type 2/85(2.2%).A total of 62 cases were detected by TAS(69.7%);including fetal sac type 18/62(20.2%),mass-type 36/62(40.4%),pelvic fluid type 8/62(9.0%).There was significant difference in detection rate between two methods(P<0.05).Conclusions:TVS is helpful in early diagnosis of acute ectopic pregnancy,and have higher positive rate and resolution.It can clearly show subtle lesions of pelvic organs,and can provide technical evidebce for diagnosis of acute ectopic pregnancy.