经阴道超声检查在异位妊娠术前诊断中的临床价值  

Clinical Value of Transvaginal Ultrasonography in the Preoperative Diagnosis of Ectopic Pregnancy

作　　者：谭玉清[1] 陈慧明 张亚俊[2] TAN Yu-qing;CHEN Hui-ming;ZHANG Ya-jun(Department of Gynecology,Jiangmen Maiernal and Child Health Hospital,Jiangmen,Guangdong Prorince,529050;Departmen of Ulrasound,Jiangmen Maternal and Child Health Hospital,Jiangmen,Guangdong Prorince)

机构地区：[1]广东省江门市妇幼保健院妇科,529050 [2]广东省江门市妇幼保健院超声科,529050

出　　处：《岭南急诊医学杂志》2021年第4期376-378,390,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:总结经阴道超声检查(TVS)在异位妊娠(EP)术前诊断准确率,评估其临床应用价值。方法:回顾性分析2018年1月至2020年12月广东省江门市妇幼保健院术前TVS检查并实施手术治疗的765例EP患者的临床资料,评估TVS及联合β-hCG、孕酮对诊断EP的价值。结果:765例中,首次TVS确诊620例(81.05%),第2次和3次TVS检查确诊97例(12.68%)、33例(4.31%)。TVS诊断后手术750例(98.04%),745例术中明确,5例术中未发现EP,为黄体出血;术前TVS检查未确认,术后组织学证实诊断15例(1.96%)。TVS的总阳性预测值为99.0%(95%CI,98.3-99.8),敏感性为98.5%(95%CI,97.6-99.2)。TVS、β-HCG和孕酮水平的联合诊断的敏感性和特异性接近100%。结论:TVS诊断EP的准确性较高,应作为EP术前的常规检查项目。Objective:To summarize the preoperative diagnostic accuracy of patients with ectopic pregnancy(EP)of transvaginal ultrasonography(TVS)and evaluate its clinical application value. Methods:The clinical data of 765 patients with EP underwent preoperative TVS and surgical treatment were retrospectively analyzed from Jan 2018 to Dec 2020 in thehospital. The value of TVS and combined β-hCG and progesterone testing in the diagnosis of EP was evaluated. Results:Among the 765 cases,620 cases(81.05%)were diagnosed in the first TVS examination,97(12.68%)cases and 33(4.31%)cases in the second and third scanning,respectively. 750(98.04%)cases were directly operated upon diagnosis,745 cases were established EP,5 cases werecorpus luteum hemorr hageand not found EP. 15(1.96%)cases preoperative misdiagnosed were correctly diagnosed based on postoperative histology. The total positive predictive value of TVS was 99.0%(95%CI,98.3-99.8),and the sensitivity was 98.5%(95% CI,97.6-99.2). The sensitivity and specificity of the combined diagnosis of TVS,β-HCG and progesterone were close to 100%. Conclusion:TVS has high accuracy in diagnosing EP and should be used as a routine examination before EP operation.

关 键 词：经阴道超声检查 异位妊娠 诊断 手术 

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]