经会阴超声对孕妇耻骨联合分离症的诊断价值

目的评价经会阴超声对孕妇耻骨联合分离症的诊断价值。方法选取2018年12月至2020年1月山西白求恩医院疑有耻骨联合分离症状晚孕期孕妇30例(研究组)、无症状晚孕期孕妇30例(对照组①)、未孕未育者30例(对照组②),采用经会阴超声测量各组耻骨联合分离间距、左右错合度,对比各组之间差异。结果研究组耻骨联合间距宽度明显大于对照组①和对照组②,差异有统计学意义(P<0.05)。当耻骨联合分离间距较宽处临界值为11.5 mm时,诊断耻骨联合分离症受试者工作特征(receiver operating characteristic,ROC)曲线下面积为0.920(95%CI:0.854-0.986,P<0.001),灵敏度、特异度分别为86.7%、76.7%;当耻骨联合分离间距较窄处临界值为4.5 mm时,诊断耻骨联合分离症ROC曲线下面积为0.819(95%CI:0.711-0.927,P<0.001),灵敏度、特异度分别为73.7%、86.7%。研究组左右错合度明显大于对照组①和对照组②,差异有统计学意义(P<0.05)。结论经会阴超声对耻骨联合分离症有较高诊断价值,当耻骨联合间距离≥11.5 mm时,可作为经会阴超声诊断耻骨联合分离症的参考值。

Diagnostic value of transperineal ultrasound in pregnant women with pubic symphysis separation

Objective To evaluate the diagnostic value of transperineal ultrasound for pregnant women with pubic symphysis diastasis.Methods From December 2018 to January 2020,30 pregnant women who were suspected of pubic symphysis separation in late pregnancy(study group),30 cases of asymptomatic late pregnancy women(control group①),30 cases of infertile(control group②)in Shanxi Bethune Hospital were selected.Trans-perineal ultrasound was used to measure the separation distance of the pubic symphysis and the degree of left and right dislocation,and compared the differences between the groups.Results The width of the joint space of the pubic symphysis in the study group was significantly larger than that in the control group①and the control group②,the differences were statistically significant(P<0.05).When the critical value of the wide separation distance of the pubic symphysis was 11.5 mm,the area under the curve of receiver operating characteristic(ROC)for the diagnosis of pubic symphysis was 0.920(95%CI:0.854-0.986,P<0.001),sensitivity and specificity were 86.7%and 76.7%respectively;when the critical value of the narrow separation distance of the pubic symphysis was 4.5 mm,the area under the ROC curve for the diagnosis of pubic symphysis was 0.819(95%CI:0.711-0.927,P<0.001),and the sensitivity and specificity were 73.7%and 86.7%,respectively.The degree of left-right mismatch in the study group was significantly greater than that in the control group①and the control group②,the difference was statistically significant(P<0.05).Conclusion Transperineal ultrasound has higher diagnostic value for symphysis pubis diastasis,and when the distance between pubic symphysis is≥11.5 mm,it can be used as a reference value for diagnosing pubic symphysis diastasis by transperineal ultrasound.