早期异位妊娠诊断方法的研究分析

目的：探讨早期异位妊娠的诊断方法。方法：将2006年1月至2012年12月本月收治的200例疑似异位妊娠患者作为研究对象，在无痛诊刮术前24h及诊刮后72h测定血清B—HCG定量、孕酮值并配合阴道彩超检查。结果：200例疑似异位妊娠患者中诊刮术后血8一HCG定量及孕酮值下降迅速者15例（考虑为宫内妊娠），其中4例经病理检查证实为输卵管妊娠。血B—HCG定量及孕酮值下降不显著或上升者185例（拟诊为异位妊娠），行腹腔镜或剖腹手术后确诊。最终确诊异位妊娠189例、宫内妊娠11例。四项指标联合应用诊断符合率达94．5％。异位妊娠患者B—HCG定量、孕酮值明显低于宫内妊娠者（P〈0．01）。、结论：无痛诊刮术前后测定血B-HCG及孕酮值，配合阴道彩超检查可以作为早期异位妊娠诊断指标，四者联合检测能明显提高早期异位妊娠的诊断符合率。

Comparison on various approaches for early diagnosis of ectopic pregnancy

Objective： To investigate the different approaches for early diagnosis of ectopic pregnancy. Methods： We conducted serum B-HCG and progesterone quantitative assays and transvaginal ultrasound （TVCD） at 24 hours prior to and 72 hours following painless dilatation and curettage of uterine in 200 patients with a suspected diagnosis of ectopic pregnancy admitted between January 2006 and December 2012. Results： Of 200 patients who received painless dilatation and curettage of uterine, 15 with susceptible intrauterine pregnancy evidenced a dramatic decline in serum B-HCG and progesterone, of whom 4 were pathologically diagnosed as having tubal pregnancy. The remaining 185 patients with susceptible ectopic pregnancy who had no reduction or increase in serum B-HCG and progesterone were further confirmed by laparoscopy or open-abdomen surgery. Finally 189 and l 1 patients were confirmed as having ectopic and intrauterine pregnancy, respectively. The combination of 4 aforementioned approaches yielded a consistency of 94. 5%. Compared with intrauterine pregnancy, patients with ectopic pregnancy were characterized by a markedly reduced level of serum B-HCG and progesterone （ both P 〈 0.05 ）. Conclusion ： Measurements of serum B-HCG and progesterone in combination with TVCD prior to and following painless dilatation and curettage of uterine may serve as an index for early diagnosis of ectopic pregnancy. The four methods combined is associated with improved consistency of the diagnosis.