经阴道彩色多普勒超声检查结合腹部推挤在诊断早期异位妊娠中的应用价值  

The value of transvaginal color Doppler combinated with abdominal palpation in the diagnosis of early ectopic pregnancy

作　　者：王伟群[1] 梁伟翔[1] 张华[1] 袁文琳[1] 黎月薇[1] 李盈[1] 

机构地区：[1]广州医学院第三附属医院医学超声科,510150

出　　处：《实用医学杂志》2012年第21期3557-3559,共3页The Journal of Practical Medicine

摘　　要：目的:运用经阴道超声(TVS)结合腹部触诊推挤卵巢时,观察附件区有无与卵巢相对运动的异常包块回声,以提高早期异位妊娠的诊断率。方法:观察126例早期异位妊娠患者(异位妊娠组)子宫内膜厚度、形态、血流分布,结合腹部触诊推挤卵巢,附件区有无与卵巢相对运动的异常包块回声,并与45例宫内早早孕患者(宫内早早孕组)相对照。结果:(1)异位妊娠组子宫内膜厚度、形态与宫内早早孕组比较差异有统计学意义(P<0.05),异位妊娠组血流阻力指数(RI)与宫内早早孕组比较差异无统计学意义(P>0.05)。(2)78.5%(99/126)异位妊娠包块回声稍高于卵巢实质回声,21.4%(27/126)异位妊娠包块回声与卵巢实质回声相近,推挤时与卵巢均有相对运动;63.4%(80/126)黄体显示环状血流,23.0%(29/126)异位妊娠包块显示环状血流,二者差异有统计学意义(P<0.01)。结论:子宫内膜厚度、形态及异位妊娠包块与卵巢的关系和回声比较,可为早期异位妊娠的鉴别诊断提供有价值的信息。Objective To enhance the diagnosis rate of early ectopic pregnancy （EP） by detecting the relative movement between EP mass and ovary combinated transvaginal color Doppler with ovarian palpation. Methods 126 cases bserved in patients who were confirmed in early EP（EP group） were detected endometrial morphology, blood perfusion and the relative movement of EP mass by TVCD, and compared with 45 cases of patients with intrauterus pregenancy（contrast group）. Results （1）There was statistically significant difference in endometrial thickness and shape （resistance index） between EP group and contrast group （P 〈 0.05）, but not in resistance index （RI） （P 〉 0.05）; （2）The ehco of 78.5%（99/126） EP mass was slightly higher than the oophoritic essence and 21.4%（27/126）EP mass was similar to the oophoritic essence by TVS. All of the EP mass had the relative motion with ovary. 63.4% （80/126） corpus luteum showed color blood flow, and in 23.0% （29/126） EP mass, the differences between the two groups were statistically significant （P 〈 0.01）. Conclusions Endometrial thickness, morphology and the relationship between EP and ovarian mass and the echo compared to the early diagnosis of ectopic pregnancy provide valuable information.

关 键 词：妊娠 异位 经阴道彩超 腹部触诊 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]