Tc-99m红细胞显像在急性活动性妇科腹腔出血诊断中的价值.docVIP

Tc-99m红细胞显像在急性活动性妇科腹腔出血诊断中的价值 【摘要】目的：通过Tc-99m红细胞标记技术，初步探讨其在妇科急性腹腔内出血诊断中的价值。方法：60例女性病人，均有停经史，后穹隆穿刺均可见不凝血，行Tc-99m-RBC显像，动态显示盆腔内有无膀胱外核素浓聚。结果：34例在实质期内可见膀胱外盆腔大小不等的同位素浓聚显像，其中偏左侧16例，右侧18例，延迟期放射性同位素浓聚仍持续存在，阳性率56.7%。26例未见明显持续性同位素浓聚。急诊手术，34例术中均证实为宫外孕伴有活动性出血。结论：Tc-99m-RBC多期成像对于妇科急性腹腔内出血的活动性及确定出血部位有一定的价值，为临床提供一种新的无创性检查技术。 【关键词】 标记红细胞，Tc-99m；腹腔内出血 Value of Tc-99m-marked Red Blood Cell in Diagnosis of Acute Gynecological Active Abdominal Bleeding FANG Guang-guang, CHEN Hong, LEI Yong, et al (The Second Peoplersquo;s Hospital of Shenzhen, Guangdong Shenzhen 518035, China) Abstract：Objective: To discuss the use of Tc-99m marked red blood cells (Tc-99m-RBC) in diagnosis of acute gynecological active abdominal bleeding. Method: Sixty female patients with history of menolipsis accepted culdocentesis and incogulable blood was observed. Tc-99m-RBC imaging was used and no radioactive concentration out of urinary bladder was seen in dynamic imaging. Result: In substantial stage, thirty-four patients showed intrapelvic radioactive concentration imaging out of the baldder, in which sixteen were in the left side and eighteen were in the right. In delayed stage, radioactive concentration still existed, with the positive rate of 56.7%. Twenty-six patients did not show persistant radioactive concentration. After emergency operation, all the thirty four patients, who used to show radioactive concentration, were proved to be ectopic pregnancy with active bleeding. Conclusion: Multiple phased Tc-99m-RBC imaging is valuable in diagnosis of acute gynecological abdominal bleeding. It has provided a new non-invasive method of clinical diagnosis. Key words： Marked red blood cells； Tc-99m; Abdominal bleeding 急性腹腔内出血是妇科临床常见的急性病症，宫外孕、黄体破裂、子宫破裂及腹膜卒中是常见病因。锝99标记红细胞（Tc-99m-RBC）显像技术是一种常用的核医学成像技术，是一种生理性检查方法，标记的自身RBC可较长时间存在于血循环中（36h），便于多次、动态检查。Smith［1］等报道只要达到5ml，就可显示出来，已广泛用于胃肠道出血的定位及定量诊断。但对于妇科腹腔内出血的诊断上尚未应用，国内外文献均未见报道。本文旨在通过Tc-99m红细胞标记技术，初步探讨其在妇科急性腹腔内出血诊断中的价值。 1 资料与方法 1.1 一般资料：60例女性病人，年龄19～37岁，平均年龄28.4岁。所有患者