超声及CDFI鉴别诊断早期宫角妊娠和间质部妊娠临床效果  

Clinical effect of ultrasound and color Doppler flow imaging for differential diagnosing the early uterine cornual pregnancy and interstitial tubal pregnancy

作　　者：余燕华 赵楼萍 边焕杰 陈阳 YU Yanhua;ZHAO Louping;BIAN Huanjie;CHEN Yang(Zhuji Maternal and Child Health Care Hospital,Zhuji,Zhejiang Province,311800)

机构地区：[1]浙江省诸暨市妇幼保健院,311800

出　　处：《中国计划生育学杂志》2024年第12期2853-2856,2860,2967,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨阴道超声及彩色多普勒血流显像(CDFI)对早期宫角妊娠(CP)和输卵管间质部妊娠(ITP)鉴别诊断效果。方法:回顾性收集2019年1月-2023年10月本院收治的异位妊娠患者110例临床资料,经病理结果诊断,CP52例纳入CP组,ITP58例纳入ITP组。比较两组一般资料、超声特征及CDFI参数。结果:CP组阴道出血占比(90.4%)高于ITP组(39.7%),宫腔完整占比(32.7%)、子宫内膜包绕占比(82.7%)、孕囊外凸占比(23.1%)低于ITP组(94.8%、100.0%、77.6%),周边肌层完整占比(94.2%)高于ITP组(25.9%),孕囊周边肌层厚度(6.20±1.65mm)、搏动指数(1.25±0.35)、阻力指数(0.58±0.10)大于ITP组(3.05±0.94mm、0.97±0.23、0.49±0.08),舒张末期最低流速(0.19±0.06)小于ITP组(0.24±0.07)(均P<0.05)。以病理结果为依据,超声和CDFI鉴别诊断CP、ITP的kappa值为0.827,灵敏度88.5%、特异度77.6%、准确率82.7%。结论:阴道超声和CDFI对早期CP、ITP鉴别诊断有较好价值。Objective:To investigate the effect of ultrasound and color Doppler flow imaging(CDFI)for differential diagnosing the early uterine cornual pregnancy(CP)and interstitial tubal pregnancy(ITP).Methods:The clinical data of 110 patients with ectopic pregnancy who were diagnosed by pathology in the hospital from January 2019 to October 2023 were analyzed retrospectively,including 52 patients with CP in group A and 58 patients with ITP in group B.The general information,the ultrasound features,and the CDFI parameters of the patients were compared between the two groups.Results:The proportion of the vaginal bleeding(90.4%)of the patients in group A was significantly higher than that(39.7%)of the patients in group B(P<0.05).The proportions of the intact uterine cavity(32.7%),the endometrial wrapping(82.7%)and the protruding gestational sac(23.1%)of the patients in group A were significantly lower than those(94.8%,100.0%and 77.6%)of the patients in group B.The proportion of the intact peripheral muscle layer(94.2%)of the patients in group A was significantly higher than that(25.9%)of the patients in group B.The values of the thickness(6.20±1.65mm),the pulsatility index(1.25±0.35)and the resistance index(0.58±0.10)of the muscle layer around the gestational sac of the patients in group A were significantly higher than those(3.05±0.94 mm,0.97±0.23 and 0.49±0.08)of the patients in group B.The minimum end diastolic velocity(0.19±0.06)of the patients in group A was significantly lower than that(0.24±0.07)of the patients in group B(all P<0.05).Based on the results of pathology,the Kappa value,the sensitivity,the specificity and the accuracy of ultrasound and CDFI for differential diagnosing CP and ITP were 0.827,88.46%,77.59%and 82.73%,respectively.Conclusion:Vaginal ultrasound and CDFI have better differential diagnostic value for the early CP and ITP of the patients.

关 键 词：宫角妊娠 间质部妊娠 阴道超声 彩色多普勒血流显像 鉴别诊断 

分 类 号：R714.22[医药卫生—妇产科学] R445.1[医药卫生—临床医学]