经阴道彩超对输卵管间质部妊娠诊断研究.docVIP

经阴道彩超对输卵管间质部妊娠诊断研究【摘要】　目的：探讨经阴道彩超在输卵管间质部妊娠的诊断与鉴别中的价值。方法：对37例输卵管间质部妊娠的超声声像图特征及术后病检结果进行回顾性分析。结果：37例输卵管间质部妊娠患者中，经阴道超声正确诊断31例，准确率83.8%，误诊6例(其中宫角部妊娠3例，残角子宫1例，双角子宫一侧妊娠1例，滋养细胞疾病1例)，误诊率为16.2%。据典型的超声声像图分为：孕囊型和包块型两种。结论：经阴道彩超是早期诊断与鉴别输卵管间质部妊娠的一种可靠的诊断方法，具有重要的临床价值。 【关键词】　经阴道超声；　彩色多普勒；　输卵管间质部妊娠；　诊断与鉴别 Transvaginal Color Doppler Ultrasound in the Diagnosis for Interstitial Tubal Pregnancy/HE Wen-yan，CAO Xiao-hui.//Medical Innovation of China，2012，9(25):075-076 【Abstract】　Objective：To explore the clinical values of transvaginal color Doppler ultrasound(TVCDU) in the diagnosis and differential of interstitial tubal pregnancy.Method：Maked retrospective analysis of Ultrasonographic features and postoperative pathological examination results of 37 cases of interstitial tubal pregnancy. Result：In 37 cases of interstitial tubal pregnancy patients，31 cases were correctly diagnosed by TVCDU，the accuracy rate is 83.8%;Six cases were misdiagnosed (three cases of misdiagnosis for the Ministry of cornual pregnancy and one cases of rudimentary uterine horn，one cases of half the side of the double uterine horn pregnancy， one cases of trophoblastic disease)，the misdiagnosis rate was 16.2%.The typical sonographic manifestations:gestational sac type and mass type.Conclusion：TVCDU is a feasible way with important clinical value for early diagnosis and differential diagnosis of tubal interstitial pregnancy. 【Key words】　Transvaginal ultrasound；　Color doppler；　Interstitial tubal pregnancy；　Diagnosis and differential First-authors address:The Chinese Medicine Hospital of Guangyuan，Guangyuan 628003，China doi：10.3969/j.issn.1674-4985.2012.25.042 输卵管间质部妊娠是临床少见而危险的异位妊娠，间质部血供丰富，一旦破裂，短时间内即可发生致命的失血性休克，故早期诊断并治疗对疾病预后有重要影响[1]。笔者对本院2006年1月-2011年12月期间37例输卵管间质部妊娠的声像图及手术病理诊断结果进行回顾性分析，探讨经阴道彩超在输卵管间质部妊娠诊断与鉴别中的临床价值。 1　资料与方法 1.1　一般资料　本院2006年1月-2011年12月经手术与病检证实37例输卵管间质部妊娠，年龄21～45岁，停经约34～81 d，血β-hCG增高，尿hCG(+)，阴道不规则流血，其中5例无停经及阴道流血病史。 1.2　仪器与方法　TOSHA-350A彩超仪，腔内探头，频率5～7.5 MHz。患者排尿后膀胱截石位，阴道探头外套避孕套后缓慢置入阴道，紧贴阴道