超声影像检查在妇产科急腹症诊断中的应用价值研究  

Study on the application value of ultrasound imaging in the diagnosis of acute abdomen in obstetrics and gynecology

作　　者：吴文娟 WU Wen-juan(Jinxiang County People's Hospital,Jining 272200,China)

机构地区：[1]金乡县人民医院,272200

出　　处：《中国实用医药》2024年第6期15-19,共5页China Practical Medicine

摘　　要：目的 探讨超声影像检查在妇产科急腹症诊断中的应用价值。方法 86例妇产科急腹症患者作为研究样本,均应用彩色多普勒超声诊断仪开展经腹部超声检查、阴道超声检查。诊断金标准为宫腔镜检查结果 ,对于在妇产科急腹症诊断时应用不同超声技术对于异位妊娠、卵巢囊肿蒂扭转、黄体破裂诊断的结果进行对比,分析不同超声方法诊断结果与宫腔镜检查结果之间的一致性情况。结果 宫腔镜诊断:86例妇产科急腹症患者中,经宫腔镜检查确诊45例异位妊娠、21例卵巢囊肿蒂扭转、20例黄体破裂。腹部超声诊断异位妊娠的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为71.11%、70.73%、70.93%、72.73%、69.05%,阴道超声分别为88.89%、90.24%、89.53%、90.91%、88.10%,腹部超声联合阴道超声诊断分别为100.00%、100.00%、100.00%、100.00%、100.00%。腹部超声、阴道超声联合检查的灵敏度、特异度、准确率、阳性预测值、阴性预测值均比单一检查更高(P<0.05)。而阴道超声单一检查的灵敏度、特异度、准确率、阳性预测值、阴性预测值均比腹部超声单一检查更高(P<0.05)。对于异位妊娠,腹部超声联合阴道超声、阴道超声单一检查与诊断金标准之间的一致性分析均达到高度, Kappa=0.884、0.740,而腹部超声单一检查与诊断金标准之间的一致性分析仅为中度, Kappa=0.657。腹部超声诊断卵巢囊肿蒂扭转的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为66.67%、83.08%、79.07%、56.00%、88.52%,阴道超声分别为76.19%、87.69%、84.88%、66.67%、91.94%,腹部超声联合阴道超声诊断分别为100.00%、98.46%、98.84%、95.45%、100.00%。腹部超声联合阴道超声的灵敏度、特异度、准确率、阳性预测值、阴性预测值均比单一检查更高(P<0.05)。对于卵巢囊肿蒂扭转,腹部超声联合阴道超声与诊断金标准之间的一�Objective To explore the application value of ultrasound imaging in the diagnosis of acute abdomen in obstetrics and gynecology.Methods 86 patients with acute abdomen in obstetrics and gynecology were selected as the research samples,and color Doppler ultrasound diagnostic equipment was used to perform transabdominal and vaginal ultrasound examinations.The gold standard for diagnosis was the results of hysteroscopy.For the diagnosis of acute abdomen in obstetrics and gynecology,different ultrasound techniques were used to compare the results of ectopic pregnancy,torsion of ovarian cyst pedicle,and rupture of corpus luteum.The consistency between the diagnostic results of different ultrasound methods and the results of hysteroscopy was analyzed.Results Hysteroscopic diagnosis:among 86 patients with acute abdomen in obstetrics and gynecology,there were 45 cases of ectopic pregnancy,21 cases of torsion of ovarian cyst pedicle and 20 cases of rupture of corpus luteum.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of abdominal ultrasound in diagnosing ectopic pregnancy were 71.11%,70.73%,70.93%,72.73%and 69.05%,and those of vaginal ultrasound were 88.89%,90.24%,89.53%,90.91%and 88.10%,and those of abdominal ultrasound combined with vaginal ultrasound were 100.00%,100.00%,100.00%,100.00%and 100.00%.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of abdominal ultrasound combined with vaginal ultrasound were higher than those of single examination(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of vaginal ultrasound were higher than those of abdominal ultrasound(P<0.05).Regarding the ectopic pregnancy,the consistency between abdominal ultrasound combined with vaginal ultrasound,single vaginal ultrasound and the gold standard reached a high level(Kappa=0.884 and 0.740),while the consistency between single abdominal ultrasound and gold standard was only moderate(Kappa=0.657).The se

关 键 词：妇产科 急腹症 异位妊娠 卵巢囊肿蒂扭转 黄体破裂 诊断 经阴道超声 腹部超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711[医药卫生—诊断学]