摘要
目的对比早期输卵管妊娠与宫内妊娠中血清血清β-HCG、孕酮及子宫内膜厚度水平,探讨联合经阴道彩色超声多普勒、血β-HCG、孕酮及子宫内膜厚度诊断对早期输卵管妊娠的价值。方法选取2015年7月至2019年7月收治的90例疑似早期输卵管妊娠患者作为研究对象,对经病理或手术证实的80例早期输卵管妊娠及10例宫内早孕孕妇进行回顾性分析,比较不同类型孕妇血清β-HCG、孕酮水平及子宫内膜厚度,评价血清β-HCG、孕酮、阴道超声联合应用在早期输卵管妊娠诊断中的意义。结果输卵管妊娠的孕妇就诊即刻血清β-HCG、孕酮水平、子宫内膜厚度较正常宫内妊娠的孕妇明显降低,且48 h后正常宫内妊娠的孕妇的血清β-HCG水平翻倍增加,差异均具有统计学意义(P<0.05)。而输卵管妊娠的孕妇48 h后血清β-HCG水平无显著性变化(P>0.05),单独采用阴道超声、孕酮、血清β-HCG及β-HCG+孕酮+超声诊断早期输卵管妊娠灵敏度分别为80.00%、67.50%、70.00%、92.50%,特异度分别为60.00%、50.00%、50.00%、90.00%,准确度分别为77.78%、65.56%、67.78%、91.11%,阳性预测值分别为94.12%、91.53%、91.80%、98.65%,阴性预测值分别为27.27%、16.13%、17.24%、56.25%。结论血清β-HCG、孕酮检查与阴道超声联合诊断早期输卵管妊娠可显著提高诊断的准确率,降低漏诊率和误诊率,建议在临床上推广。
Objective To compare the levels of bloodβ-HCG,progesterone and endometrial thickness in early tubal pregnancy and intrauterine pregnancy,and explore the combined transvaginal color Doppler,bloodβ-HCG,progesterone and endometrial thickness diagnosis value of early tubal pregnancy.Methods 90 patients with suspected early fallopian tube pregnancy who were treated from July 2015 to July 2019 were selected as the research objects.Retrospective analysis was performed on 80 cases of early fallopian tube pregnancy and 10 cases of intrauterine pregnancy confirmed by pathology or surgery.Serumβ-HCG,progesterone levels and endometrial thickness of different types of pregnant women were compared.The significance of combined application of serumβ-HCG,progesterone and vaginal ultrasound in the diagnosis of early fallopian tube pregnancy were evaluated.Results The levels of serumβ-HCG,progesterone,and endometrial thickness of pregnant women with tubal pregnancy were significantly lower than those of normal intrauterine pregnancy,and the serumβ-HCG levels of pregnant women with normal intrauterine pregnancy doubled after 48 hours.It has statistical significance(P<0.05).For pregnant women with tubal pregnancy,there was no significant change in serumβ-HCG levels after 48 h(P>0.05).The sensitivity of early diagnosis of early fallopian tube pregnancy using vaginal ultrasound,progesterone,serumβ-HCG andβ-HCG+progesterone+ultrasound were 80.00%,67.50%,70.00%,92.50%,respectively,specificity of 60.00%,50.00%,50.00%,90.00%,respectively,accuracy of 77.78%,65.56%,67.78%,91.11%,respectively,and positive predictive value of 94.12%,91.53%,91.80%,98.65%,respectively,and negative predictive values were 27.27%,16.13%,17.24%,and 56.25%.Conclusion The combination of serumβ-HCG,progesterone examination and vaginal ultrasound in the early diagnosis of tubal pregnancy can significantly improve the accuracy of diagnosis,reduce the rate of missed diagnosis and misdiagnosis,and it is recommended to be promoted clinically.
作者
马哲
MA Zhe(Traditional Chinese Medicine Hospital of Shaanxi,Xi′an 710003,China)
出处
《延安大学学报（医学科学版）》
2020年第2期20-23,共4页
Journal of Yan'an University:Medical Science Edition
