三种超声途径测宫颈长度预测早产的对比性分析

发布时间：2018-06-07 10:31

  本文选题：超声 + 宫颈长度　； 参考：《中南大学》2014年硕士论文

【摘要】：目的探讨超声测宫颈长度预测早产的临床意义,并对经腹、经阴道与经会阴三种超声途径测宫颈长度预测早产进行比较。对象及方法对2012年1月至2014年1月有先兆早产征象来我院就诊的孕妇行超声测宫颈长度预测早产,经腹扫查278例(经腹组)、经阴道扫查297例(经阴道组)、经会阴扫查301例(经会阴组),记录宫颈长度(CL)并追踪妊娠结局,并对三种方法进行比较。结果①孕妇接受率经腹组为100%,经阴道组为81.1%,经会阴组为99.3%,经阴道组孕妇接受率明显低于经腹组和经会阴组,P0.01,有极显著统计学差异。②宫颈实现率经腹组为84.2%,经阴道组为98.8%,经会阴组为98.3%,经腹组宫颈实现率明显低于经阴道组和经会阴组,P0.01,有非常显著统计学差异。③顺利完成检查共766例,其中共164例早产,602例足月产,按CL2.0cm、2.0cm≤CL2.5cm、2.5≤CL3.0cm、3.0≤CL3.4cm, CL≥3.5cm分组分别预测早产的敏感性、特异性、阳性预测值及阴性预测值,发现CL3.0cm时发生早产的敏感性和特异性之和为最大值。④经腹组CL3.Ocm孕妇早产率为54.3%,经阴道组为55.1%,经会阴组为56.3%, CL≥3.0cm孕妇早产率经腹组为9%,经阴道组为8.1%,经会阴组为8.6%,三组CL3.0cm和CL≥3.0cm孕妇早产率比较均有明显差异,有统计学意义。⑤CL3.0cm预测早产敏感性经腹组为51.4%,经阴道组为76.8%,经会阴组为76.1%,经腹组明显低于经阴道组和经会阴组,P0.01,有非常显著统计学差异。结论①超声测宫颈长度预测早产是有较大临床意义的,无论是经腹,经阴道还是经会阴测量。②宫颈长度3.0cm时,敏感性和特异性之和最大,即将3.0cm作为测量宫颈长度预测早产的临界值,以宫颈长度3.0cm诊断为宫颈异常,预测早产准确性最高,最具有临床意义,可作为预防早产的界值。③综合比较经会阴途径测宫颈长度更具优势,值得推广。图6幅,表5个,参考文献31篇。
[Abstract]:Objective to explore the clinical significance of cervical length measurement by ultrasonography in preterm labor and to compare the cervical length prediction by transabdominal transvaginal and perineal ultrasound. Participants and methods pregnant women who had signs of premature labor from January 2012 to January 2014 were measured by ultrasound to predict the length of cervix. 278 cases were examined by abdominal scan (transabdominal group, 297 cases by vagina scan (transvaginal group), 301 cases by perineum scan (transperineal group, cervical length CLL), and pregnancy outcome was tracked, and the three methods were compared. Results 1 the acceptance rate of pregnant women was 100 in the abdominal group, 81.1 in the vaginal group and 99.3 in the perineum group. The acceptance rate of pregnant women in the vaginal group was significantly lower than that in the abdominal group and the perineum group (P 0.01). The cervical realization rate in the transabdominal group was significantly lower than that in the vaginal group and the transperineal group (P 0.01). There was a very significant difference between the two groups (766 cases). A total of 602 cases of preterm labor were diagnosed. According to CL2.0 cm ~ (2. 0) cm 鈮，

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