经阴超声结合血清因子检测早期异位妊娠的临床价值  

Clinical value of trans-ultrasonography combined with serum factor in diagnosis of early ectopic pregnancy

作　　者：张婷婷 朱文娜 曹娜[3] 徐俊荣[4] 尹晓燕[1] ZHANG Tingting;ZHU Wenna;CAO Na(Department of Ultrasound,The Fourth Hospital of Hengshui City,Hebei,Hengshui 053000,China)

机构地区：[1]河北省衡水市第四人民医院超声诊断科,053000 [2]河北省阜城县人民医院超声诊断科 [3]河北省衡水市第四人民医院检验科,053000 [4]河北省衡水市第四人民医院妇产科,053000

出　　处：《河北医药》2018年第6期861-865,共5页Hebei Medical Journal

基　　金：河北省衡水市重点研发计划项目(编号:2017014019Z)

摘　　要：目的探讨经阴超声结合血清因子水平检测早期异位妊娠的临床价值,为临床诊治提供参考依据。方法选取200例异位妊娠疑似患者作为研究组,另选取同期来我院接受体检的200正常妊娠女性作为对照组,均接受经阴超声检查及血清指标检测,观察人绒膜促性腺激素(β-HCG)、孕酮水平及子宫内膜厚度,评估经阴超声结合血清β-HCG、孕酮联合检测灵敏度及特异度、准确率。结果研究组阴道出血、腹部压痛、宫颈举痛及附件区压痛明显高于对照组,差异有统计学意义(P<0.05);2组子宫压痛差异无统计学意义(P>0.05);研究组子宫增大明显高于对照组,差异有统计学意义(P<0.05)。研究组患者子宫内膜厚度及血清β-HCG、孕酮水平均低于对照组,差异有统计学意义(P<0.05);经阴超声、血清β-HCG、孕酮单项检测早期异位妊娠具有一定临床诊断价值,但联合检测灵敏度、特异度、准确率均高于单项检测(P<0.05),联合检测灵敏度、特异度、准确率分别为94.0%、95.5%、94.5%,在诊断早期异位妊娠方面应用价值更高。结论采用经阴超声结合血清因子水平检测能提高早期异位妊娠诊断敏感性及特异性、准确性,临床应用价值高,值得临床推广。Objective To investigate the clinical value of trans-ultrasonography combined with serum factor in diagnosis of early ectopic pregnancy in order to provide reference for clinical diagnosis and treatment.Methods A total of 200 patients with ectopic pregnancy who were treated in our hospital from January 2015 to May 2017 were enrolled as observation groupand the other 200 normal pregnant women who received physical examination in our hospital were enrolled as control group.All the subjects were examined by trans-ultrasonography and serum indexes detection.The levels of human chorionic gonadotropic hormone(β-HCG),progesterone and endometrial thickness were observed and compared between two groups.Moreover the sensitivity,specificity and accuracy of trans-ultrasonography and serum indexes detection were evaluated and compared between two groups.Results The ovaginal bleeding,abdominal tenderness,cervical lifting pain and adnexal tenderness in observation group were significantly higher than those in control group(P<0.05),however,there was no significant difference in uterine tenderness between two groups(P>0.05).The uterine enlargement in observation group was much more obvious than that in control group(P<0.05).However the thickness of endometrium,the serum levels ofβ-HCG and progesterone in observation group were significantly lower than those in control group(P<0.05).The sensitivity,specificity and accuracy of combined detection sensitivity were 94.0%,95.5%and 94.5%,respectively.The sensitivity,specificity and accuracy of the combined detection sensitivity were significantly higher than those by simple detction in diagnosis of early ectopic pregnancy(P<0.05).Conclusion The transvaginal ultrasound combined with serum factor detection can improve the sensitivity,specificity and accuracy in diagnosis of of early ectopic pregnancy,therefor,which is worth using widely in clinical practice.

关 键 词：经阴超声 孕酮 血清Β-HCG 早期异位妊娠 

分 类 号：R714.22[医药卫生—妇产科学]