宫外孕阴道超声23例漏诊误诊分析.docVIP

宫外孕阴道超声23例漏诊误诊分析 　　摘 要 目的:探讨异位妊娠阴道超声漏诊及误诊发生的原因,以提高阴道超声诊断准确率。方法:对本资料23例异位妊娠病例的阴道超声漏诊、误诊进行回顾分析。结果:23例患者中误诊为盆腔炎性包块者5例,黄体破裂者2例,宫内宫外复合妊娠2例,宫内早早孕者4例,不全流产2例,子宫肌壁间妊娠误诊2例,卵巢肿大2例、输卵管积液1例、宫内孕1例、2例宫内及附件未见明显异常。结论:阴道超声对异位妊娠误诊、漏诊原因很多,医生必须认真采集临床资料,仔细检查,全面考虑诊断,在宫内外均未见明显孕囊及高度怀疑异位妊娠时,必须结合尿HCG或血HCG检查,并结合阴道彩色多普勒超声检查、临床症状进行全面分析诊断。 　　关键词 异位妊娠 阴道超声检查 误诊 漏诊 　　doi:10.3969/j.issn.1007-614x.2010.17.072? 　　AbstractObjective:To explore the missed diagnosis of ectopic pregnancy,transvaginal ultrasonography and misdiagnosis can occur because in order to improve diagnostic accuracy of transvaginal sonography.Methods:23 cases of ectopic pregnancy this information vaginal ultrasound missed cases of misdiagnosis were analyzed retrospectively.Results:23 cases of missed diagnosis,misdiagnosis for Pelvic Inflammatory mass in 5 cases,corpus luteum rupture in 2 cases,2 cases of intrauterine pregnancy,extrauterine compound,intrauterine early pregnancy in 4 cases,2 cases of incomplete abortion,uterine muscle wall misdiagnosed two cases of inter-pregnancy,ovarian enlargement in 2 cases, 1 case of tubal fluid,intra-uterine pregnancy in 1 case,2 cases had no obvious intra-uterine and accessories.Conclusion:The transvaginal sonography of ectopic pregnancy misdiagnosis are many reasons,doctors must carefully collect clinical data,double-check,take full account of the diagnosis, in the uterus were no significant pregnancy outside the capsule and a high degree of suspicion of ectopic pregnancy,must be combined urine HCG,or HCG blood examination,combined with transvaginal color Doppler ultrasound examination,clinical symptoms,to conduct a comprehensive analysis and diagnosis. 　　KeywordsEctopic pregnancy;transvaginal ultrasound examination;misdiagnosis;missed 　　资料与方法 　　2005年2月～2009年3月在我院用阴道超声检查或外院超声检查到我院作阴道超声复查的23例异位妊娠,通过手术和病理检查确诊;23例患者年龄18～43岁,未婚2例,初孕5例;其中有停经史者19例、宫内有节育环者10例;停经时间33～72天不等,无停经史者4例。其中阴道超声漏诊6例,误诊15例。23例中,就诊前有不同程度腹痛及不规则阴道流血者17例,无腹痛及无阴道流血者5例。B超检查前作了尿HCG检查22例,尿HCG弱阳性者5例,阳性者17例,1例做超声前未查尿HCG。 　　仪器和方