孕期宫颈超声报告的质量现况分析

目的评估不同年资以及是否有专业背景的超声医师孕期宫颈超声检查的报告质量。 方法从超声医学影像工作站导出并选择2019年1月1日至12月31日北京协和医院经会阴与经阴道超声孕期检查宫颈的超声报告624份。检查医师分为第1年住院医师（G1组）、第2~3年住院医师（G2组）和专业医师（G3组）。参考加拿大妇产科医师协会母胎医学专业委员会指南，由2位工作经验＞10年的超声医师对上述图文报告进行评估，分为符合、不符合，通过χ²检验或Fisher精确检验进行组间比较。 结果满足入选标准与排除标准的624份宫颈超声检查报告中，经会阴超声检查507份（81.2%，507/624），经阴道超声检查117份（18.8%，117/624）。G1组、G2组、G3组检查医师人数分别为：16名、33名、13名。经会阴超声检查，G1组、G2组、G3组的总报告数分别为90份、326份、91份，其符合率分别为74.4%（67/90）、85.9%（280/326）、86.8%（79/91），G1与G2组、G1与G3组比较，差异有统计学意义（χ²=6.678，P=0.010；χ²=4.438，P=0.035），G2与G3组比较，差异无统计学意义（P＞0.05）。经阴道超声检查，G1+G2组、G3组的总报告数分别为44份、73份，其符合率分别为75.0%（33/44）、91.8%（67/73），2组比较差异有统计学意义（χ²=6.225，P=0.013）。相同年资医师经会阴与经阴道宫颈超声检查的符合率之间比较，差异无统计学意义（P＞0.05）。 结论经阴道超声宫颈检查专业组医师符合率较高，经会阴超声检查符合率随着年资增高而增高。病例积累和标准化专业培训是提高孕期宫颈超声检查的有效途径。

Quality analysis of cervical ultrasound reports for pregnant women

ObjectiveTo analyze the quality of cervical ultrasound during pregnancy among ultrasound physicians with different working experience and professional training. MethodsAll 624 cervical ultrasound reports [transperineal ultrasound (TPU) and transvaginal ultrasound (TVU)] from January 1 to December 31, 2019 at Peking Union Medical College Hospital were derived from the ultrasound medical imaging workstation. The examiners were divided into first-year residents (G1), second- or third-year residents (G2), and professional doctors (G3). According to the guidelines published by the Society of Obstetricians and Gynaecologists of Canada Maternal-Fetal Medicine Committee, the above reports were evaluated and classified as true or false by two ultrasound physicians with more than 10 years of experience. Chi-square test or Fisher's test was used to compare the difference between groups. ResultsA total of 624 cervical examinations were recruited, 507 (81.2%, 507/624) by TPU and 117 (18.8%, 117/624) by TVU. The number of physicians in G1, G2, and G3 was 16, 33, and 13, respectively. By TPU, the total number of reports in G1, G2, and G3 was 90, 326, and 91, and the accuracy was 74.4% (67/90), 85.9% (280/326), and 86.8% (79/91), respectively; the difference between G1 and G2 and between G1 and G3 was significant (χ²=6.678, P=0.010; χ²=4.438, P=0.035), but the difference between G2 and G3 was not significant (P＞0.05). By TVU, the total number of reports in G1+G2 and G3 was 44 and 73, and the accuracy was 75.0% (33/44) and 91.8% (67/73), respectively; the difference was significant (χ²=6.225, P=0.013). The difference between TPU and TVU was not significant (P＞0.05). ConclusionThe accuracy of TVU among physicians in the professional group is higher, and the accuracy of TPU increases with the increase of seniority. Case accumulation and standardized professional training are effective ways to improve pregnant cervical ultrasonography.