【作者】 徐红；

【导师】 杨太珠；

【作者基本信息】 四川大学 ， 妇产科， 2007， 硕士

【摘要】 目的：通过经阴道黑白超声与经阴道彩色多普勒超声诊断早期异位妊娠的对比研究，探讨经阴道彩色多普勒超声诊断异位妊娠的价值及鉴别诊断价值。方法：1．以90例临床拟诊为异位妊娠的患者作为病例组，均同时进行经阴道黑白超声检查(TVS)和经阴道彩色多谱勒血流显像(TVS-CDFI)，以手术结果为诊断的金标准，将TVS及TVS-CDFI诊断结果分别与手术结果比较，评价TVS-CDFI诊断异位妊娠的价值。2．纳入20例正常早孕者作为对照组，采用TVS-CDFI测量病例组及对照组的子宫动脉及滋养层动脉血流频谱参数(RI、VS、VD)，根据手术结果分组，将组间动脉血流参数采用单因素方差分析(One-Way ANOVA)，评价组间血流参数有无差异，探讨经阴道彩色超声检查鉴别诊断价值。结果：1．90例研究对象，手术确诊异位妊娠76例，黄体破裂3例，附件炎性包块11例，以手术结果为诊断异位妊娠的金标准，经阴道彩色超声(TVS-CDFI)诊断异位妊娠的敏感性100％，准确性97.7％，特异性85.7％，阳性预测值97.4％，阴性预测值100％；经阴道黑白超声(TVS)诊断异位妊娠的敏感性97.3％，准确性92.2％，特异性64.3％，阳性预测值93.6％，阴性预测值81.8％。经阴道彩色超声对早期异位妊娠的诊断具有更大的临床价值。2.20例对照组与90例病例组根据手术结果分为四组，四组间方差分析结果：子宫动脉血流阻力指数(RI)无显著差异性；病灶周围血流阻力指数(RI)有显著差异性。结论：经阴道彩色超声检查是诊断早期异位妊娠的重要方法之一，经阴道彩色超声检查在诊断异位妊娠时较黑白超声检查能为临床提供更准确的超声诊断，对异位妊娠与炎性包块及黄体破裂病人的鉴别诊断能提供更多的超声诊断信息，对于三种疾病的鉴别诊断具有临床价值。更多还原

【Abstract】 Objective:To evaluate the diagnosis and differentiate diagnosis valueof tansvaginal color sonography (TVS-CDFI) in ectopicpregnancy compared with transvaginal sonography(TVS).Methods:1.90 patients suspected of ectopic pregnancy wereprospectively enrolled in this study. TVS-CDFI、TVS andsurgical dignosis were carried out. The findings of surgicaldiagnosis were regarded as diagnosticgoldstandard. Comparedthe result of TVS-CDFI and TVS, analysis software of x~2Tec, evaluate the diognosis value of TVS-CDFI.2.20 patientsdisgnosed of early intrauterine pregnancy were enrolled in this study as control group .Measured their and case group’sCDFI-blood parameter, analysis with One-Way ANOVA,evaluate the differentiate diognosis value of TVS-CDFI.Results 1.76 of 90 patients were ectopic pregnancy diagnosed bysurgery and 14 patients were non-ectopic pregnancy (including11 cases adnexal inflammation of ,3 cases of lutealrupture) .The sensitivety、specificity、accuracy、positivepredictive value and negative predictive value of TVS-CDFIwas 100%、85.7%、97.7%、97.4%、100%; .The sensitivety、specificity、accuracy、positive predictive value and negativepredictive value of TVS was 97.3%、64.3%、92.2%、3.6%、81.8%.TVS-CDFI have better accuracy in ectopic pregnancydiagnosis than TVS. 2.20 controll group and 90 case grouppatients were divided into 4 groups by the result of surgery.Their blood parameter analysed by One-Way ANOVA: theuterine arery resistant index (RI) between groups has nosignificant difference,the focus blood parameter RI betweengroups has significant difference.Conclusion TVS-CDFI is one of the important means in ectopicpregnancy diagnose. TVS-CDFI have better accuracy in ectopicpregnancy diagnosis than TVS,at the same time TVS-CDFI hasimportant value in differentiate adnexal inflammation and lutealrupture.更多还原