经阴道三维超声在曼月乐宫内节育器位置异常诊断中的应用  

Application value of transvaginal three-dimensional ultrasound in the location of Mirena intrauterine device

作　　者：戴翠芳 尹秀英 黄琳 DAI Cui-fang;YIN Xiu-ying;HUANG Lin(Department of Ultrasound,Jiangmen Maternal and Child Health.Hospital,Jiangmen 529000,Guangdong,CHINA)

机构地区：[1]江门市妇幼保健院超声科,广东江门529000

出　　处：《海南医学》2021年第5期633-635,共3页Hainan Medical Journal

基　　金：广东省江门市卫生健康局科学技术研究项目(编号:20A023)。

摘　　要：目的探究经阴道三维超声在诊断曼月乐宫内节育器(IUD)位置异常中的应用价值。方法选择江门市妇幼保健院2020年4~11月接诊的90例疑似曼月乐IUD位置异常者作为研究对象,分别行经阴道二维超声和经阴道三维超声检查。以宫腔镜检查为"金标准",观察并比较二维、三维超声在各类型曼月乐IUD位置异常上的检出情况,对比两种检查方法的敏感度、特异度、准确度、阳性预测值和阴性预测值。结果经宫腔镜检查证实,67例明确诊断为IUD位置异常,IUD位置异常率为74.44%;经阴道三维超声在检出各类型曼月乐IUD位置异常上的总检出率为94.03%,明显高于经阴道二维超声的76.12%,差异有统计学意义(P<0.05);经阴道三维超声在检出曼月乐IUD位置异常上的敏感度、特异度、准确度以及阳性预测值、阴性预测值分别为94.03%、95.65%、93.33%、98.44%、80.77%,明显高于经阴道二维超声的76.12%、73.91%、75.56%、89.47%、51.52%,差异均有统计学意义(P<0.05)。结论经阴道三维超声能够完整、清晰地显示曼月乐IUD形态及位置变化,在诊断曼月乐IUD位置异常上的准确度明显高于二维超声,值得在临床上推广应用。Objective To research the application value of transvaginal three-dimensional ultrasound in the diagnosis of the position of Mirena intrauterine device(IUD).Methods A total of 90 cases of suspected abnormal IUD position of Mirena in Jiangmen Maternal and Child Health Hospital from April 2020 to November 2020 were selected as the research objects,and transvaginal two-dimensional ultrasound and transvaginal three-dimensional ultrasound were performed respectively.Taking hysteroscopy as the"gold standard",the detection of two-dimensional and three-dimensional ultrasound on the abnormal IUD of Mirena were observed and compared.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of the two methods were compared.Results Confirmed by hysteroscopy,67 patients were diagnosed with abnormal location of IUD,the abnormal rate of IUD was 74.44%;the total detection rate of transvaginal three-dimensional ultrasound in the detection of various types of Mirena IUD abnormal position was 94.03%,significantly higher than 76.12%of transvaginal two-dimensional ultrasound(P<0.05);the specificity,accuracy,positive predictive value,and negative predictive value of transvaginal three-dimensional ultrasound in detecting the abnormal IUD position of Mirena were 94.03%,95.65%,93.33%,98.44%,80.77%,respectively,which were significantly higher than corresponding 76.12%,73.91%,75.56%,89.47%,51.52%of transvaginal two-dimensional ultrasound(all P<0.05).Conclusion Transvaginal three-dimensional ultrasound can completely and clearly show the shape and position changes of Mirena IUD,and its accuracy in the diagnosis of abnormal position of Mirena IUD is significantly higher than that of two-dimensional ultrasound,which is worthy of active promotion in clinical practice.

关 键 词：经阴道三维超声 经阴道二维超声 曼月乐宫内节育器 位置异常 

分 类 号：R713.3[医药卫生—妇产科学]