超声诊断异位妊娠的准确率及其影响因素分析  

Analysis of the Accuracy of Ultrasound Diagnosis of Ectopic Pregnancy and its Influencing Factors

作　　者：徐红 XU Hong(Department of Ultrasound,Longnan Hospital of Traditional Chinese Medicine,Longnan 341700,Jiangxi,China)

机构地区：[1]龙南中医院超声科,江西龙南341700

出　　处：《医学信息》2025年第8期140-143,共4页Journal of Medical Information

摘　　要：目的 评价超声诊断异位妊娠的准确率及其影响因素。方法 选取2021年1月-2023年10月龙南中医院进行治疗的60例疑似异位妊娠的患者作为研究对象,入院前或入院后均进行超声诊断,将尿TT+、血HCG降低、后穹窿穿出不凝血、超声复检及手术方法综合所得结论作为金标准,分析超声在异位妊娠诊断中的价值,并分析超声诊断异位妊娠漏诊和误诊的独立危险因素。结果 超声诊断异位妊娠的阳性预测值为97.44%、阴性预测值为80.95%、敏感度为90.48%、特异度为94.44%、准确度为91.67%、约登指数为84.92%、误诊率为5.56%、漏诊率为9.52%;单因素分析显示,患者不同BMI、盆腔积液、血清β-hCG降低、停经时间及不明部位妊娠是导致超声诊断异位妊娠准确性的影响因素(P<0.05);多因素分析显示,BMI≥28.0 kg/m2、盆腔积液、血清β-hCG降低、停经时间>6周及不明部位妊娠是影响超声诊断异位妊娠准确性的独立危险因素(P<0.05)。结论 超声诊断技术在输卵管异位妊娠早期筛查中临床诊断率较高,但仍然存在一定的误诊和漏诊率。而导致误诊和漏诊的原因是多方面的,因此需采取针对性相应措施以减少可能导致误诊和漏诊出现的原因。Objective To evaluate the accuracy of ultrasound in the diagnosis of ectopic pregnancy and its influencing factors.Methods A total of 60patients with suspected ectopic pregnancy who were treated in Longnan Hospital of Traditional Chinese Medicine from January 2021 to October 2023were selected as the research objects.Ultrasound diagnosis was performed before or after admission.Urinary TT +,decreased blood HCG,posterior fornix perforation without coagulation,ultrasound reexamination and surgical methods were used as the gold standard to analyze the value of ultrasound in the diagnosis of ectopic pregnancy,and the independent risk factors of missed diagnosis and misdiagnosis of ectopic pregnancy by ultrasound were analyzed.Results The positive predictive value,negative predictive value,sensitivity,specificity,accuracy,Youden index,misdiagnosis rate and missed diagnosis rate of ectopic pregnancy diagnosed by ultrasound were 97.44%,80.95%,90.48%,94.44%,91.67%,84.92%,5.56% and 9.52%,respectively.Univariate analysis showed that different BMI,pelvic effusion,decreased serum β-hCG,menopause time and unexplained pregnancy were the influencing factors of the accuracy of ultrasound diagnosis of ectopic pregnancy( P <0.05).Multivariate analysis showed that BMI≥28.0 kg/m2,pelvic effusion,decreased serum β-hCG,menopause time>6 weeks and unexplained pregnancy were independent risk factors affecting the accuracy of ultrasound diagnosis of ectopic pregnancy(P<0.05).Conclusion Ultrasound diagnosis technology has a high clinical diagnosis rate in early screening of tubal ectopic pregnancy,but there are still some misdiagnosis and missed diagnosis rates.There are many reasons for misdiagnosis and missed diagnosis,so corresponding measures should be taken to reduce the possible causes of misdiagnosis and missed diagnosis.

关 键 词：超声诊断 异位妊娠 诊断价值 误诊 漏诊 

分 类 号：R445.1[医药卫生—影像医学与核医学]