经阴道彩色多普勒超声联合血清β-HCG诊断子宫切口妊娠  

Diagnostic value of transvaginal color Doppler ultrasound combined with serum β-human chorionic gonadotropin level for u-terine incision pregnancy

作　　者：余奕[1] 黄菊霞 胡金花[1] 夏群[1] 夏天[1] 吴方玲 梁宇鸣 YU Yi;HUANG Juxia;HU Jinhua;XIA Qun;XIA Tian;WU Fangling;LIANG Yuming(The First Peoples Hospital of Anqing,Anhui Province,246000;Anqing Medical College)

机构地区：[1]安徽省安庆市第一人民医院,246000 [2]安庆医药高等专科学校

出　　处：《中国计划生育学杂志》2022年第7期1560-1563,1568,共5页Chinese Journal of Family Planning

基　　金：安徽省教育厅2020年高等学校省级质量工程项目助产专业教学团队(2020jxtd160);安徽省教育厅2021年高校优秀拔尖人才学术资助项目(gxbjZD2021030);2016年度广东医科大学校院联合科研基金立项项目(L2016033)。

摘　　要：目的:探讨经阴道彩色多普勒超声联合血清β-人绒毛膜促性腺激素(β-HCG)对子宫切口妊娠的诊断价值.方法:选取2018年2月-2021年11月本院收治的90例疑似子宫切口妊娠孕妇临床资料,经手术病理检查确诊46例为正常妊娠(正常妊娠组),44例为子宫切口妊娠(子宫切口妊娠组),采用酶联免疫吸附法检测血清β-HCG水平,彩色多普勒超声诊断仪经阴道检查子宫孕囊情况;分析经阴道彩色多普勒超声、血清β-HCG检出子宫切口妊娠与临床病理诊断一致性及诊断子宫切口妊娠价值.结果:子宫切口妊娠组血清β-HCG水平(1768.24±421.74U/L)高于正常妊娠组(1020.83±302.44U/L)(P<0.05).经阴道彩色多普勒超声、血清β-HCG确诊子宫切口妊娠分别为37例、34例,与临床病理诊断的一致性均为较高(Kappa=0.710、0.598,均P<0.05),二者联合确诊子宫切口妊娠41例,与临床病理诊断一致性极好(Kappa=0.889,P<0.05).与血清β-HCG检测比较,联合经阴道彩色多普勒超声诊断子宫切口妊娠的敏感度(90.9%)、准确率(94.4%)、阴性预测值(91.8%)均升高,漏诊率(2.2%)降低(均P<0.05).结论:经阴道彩色多普勒超声联合血清β-HCG可提高检出子宫切口妊娠,减少漏诊.Objective: To investigate the value of transvaginal color Doppler ultrasound combined with serum β-human chorionic gonadotropin(β-HCG) level of women for diagnosing their uterine incision pregnancy. Methods: From February 2018 to November 2021, 90 women with suspected uterine incision pregnancy were selected as the research objects, which included 46 cases with normal pregnancy in group A and 44 cases with uterine incision pregnancy in group B after confirmed by surgical pathology. Enzyme linked immunosorbent assay(ELISA) was used to detect the level of serum β-HCG of these women, and the sac situation of these women was examinated by transvaginal color Doppler ultrasound. The consistency of results of transvaginal color Doppler ultrasound or serum β-HCG level, and clinical pathological for diagnosing uterine incision pregnancy was analyzed. And the values of transvaginal color Doppler ultrasound, the serum β-HCG level, and the examination of ultrasound combined with serum β-HCG level for diagnosing uterine incision pregnancy were also analyzed. Results: The level of serum β-HCG(1768.24±421.74 U/L) of the patients in group B was significantly higher than that(1020.83±302.44 U/L) of the patients in group A(P<0.05). Transvaginal color Doppler ultrasound and serum β-HCG level confirmed uterine incision pregnancy in 37 cases and 34 cases, respectively, which had high consistency with the clinicopathological diagnosis of uterine incision pregnancy(Kappa=0.710, 0.598, all P<0.05). 41 cases with uterine incision pregnancy were confirmed by the combination of transvaginal color Doppler ultrasound and the serum β-HCG level, which had excellent consistency with the clinicopathological diagnosis(Kappa=0.889, P<0.05). The sensitivity(90.9%), the accuracy(94.4%), and the negative predictive value(91.8%)of the combination of transvaginal color Doppler ultrasound and the serumβ-HCG level for diagnosing uterine incision pregnancy were significantly higher than those of the serumβ-HCG level or ultrasound alone,and th

关 键 词：子宫切口妊娠 经阴道彩色多普勒超声 Β-人绒毛膜促性腺激素 诊断价值 

分 类 号：R714.22[医药卫生—妇产科学]