经阴道彩超联合尿hCG定量动态监测对早孕期阴道流血预后评估的价值  

Assessment Value of Transvaginal Color Doppler Ultrasound Combined with Urinary h CG Quantitative Dynamic Monitoring of Vaginal Bleeding in Early Pregnancy Prognosis

作　　者：李国宏[1] 刘干[1] 谭步巧[1] 

机构地区：[1]广东省开平市中心医院,广东开平529300

出　　处：《中国医学创新》2015年第23期103-106,共4页Medical Innovation of China

基　　金：江门市卫生系统医学科研立项项目(12A127)

摘　　要：目的:探讨经阴道彩超联合尿h CG定量动态监测对早孕期阴道流血预后评估的价值。方法:收集2012年4月-2015年3月本院门诊及住院部接诊的早孕期阴道流血并要求保胎治疗的589例患者的临床资料,按妊娠结局将其分为正常妊娠324例(A组)、自然流产162例(B组)、异位妊娠75例(C组)、葡萄胎28例(D组),四组进行了超声影像与临床观察的对比性研究。结果:A组及B组的子宫内可见孕囊,但发育情况有明显差异。A组的孕囊最大径每周增长大于10 mm的比例明显高于B组,差异有统计学意义(P<0.01),同时A组的尿h CG定量每48小时增长比率≥200的比例明显高于B组,差异有统计学意义(P<0.01)。C组及D组子宫内未能显示正常孕囊结构,但尿h CG定量每48小时增长比率比较差异有统计学意义(P<0.01)。结论:阴道彩超通过宫内外检查孕囊最大径增长值,同时联合尿h CG定量48 h增长比率,能够准确判断早孕期阴道流血的性质,可为临床分析疾病性质、制定治疗方案、评价疗效提供科学依据。Objective： To investigate the assessment value of transvaginal color Doppler ultrasound combined with urinary hCG quantitative dynamic monitoring of vaginal bleeding in early pregnancy prognosis.Method： The clinical data of 589 outpatients and inpatients with vaginal bleeding in early pregnancy who required tocolytic therapy from April 2012 to March 2015 were collected.According to the pregnancy outcome, they were divided into 324 cases of normal pregnancy （the group A ）, 162 cases of spontaneous abo^ion （ the group B ）, 75 cases of ectopic pregnancy （ the group C ）, 28 cases of hydatidiform mole （ the group D ） .The comparative study of ultrasound imaging and clinical observation of the four groups was carried out.Result： Intrauterine gestational sac was seen in the group A and the group B, but there were significant differences in the development conditions. The proportion of maximum diameter of gestational sac increased more than 10 mm per week in the group A was significantly higher than the group B, the difference was statistically significant （ P〈0.01 ） .While the proportion of the growth rate of urinary hCG quantification every 48 hours more than 200 was significantly higher than the group B, the difference was statistically significant （ P〈0.01 ） .The structure of normal pregnancy capsule in the uterus could not be displayed in the group C and the group D, but there was statistically significant difference in the growth rate of urinary hCG quantification every 48 hours （ P〈0.01 ） . Conclusion： Transvaginal color Doppler ultrasound check the maximum diameter of the gestational sac through the inside and outside inspection,, at the same time, combined with 48 h growth rate of urinary hCG quantification, can accurately determine the nature of vaginal bleeding in early pregnancy, can provide scientific basis for the clinical analysis of the nature of the disease, the development of treatment plan, evaluation of efficacy.

关 键 词：经阴道彩超 尿h CG定量 早孕期 阴道流血 

分 类 号：R714.2[医药卫生—妇产科学]