输卵管妊娠早期诊断的临床前瞻性研究

发布时间：2018-03-02 13:14

本文选题：输卵管妊娠　切入点：腹腔液　出处：《生殖与避孕》2015年07期 　论文类型：期刊论文

【摘要】：目的:探讨输卵管妊娠的早期诊断方法。方法:停经45 d内的可疑早期异位妊娠患者83例,行阴道后穹隆穿刺取得腹腔液,同时进行腹腔液及静脉血清β-hCG、E2、P定量测定,以腹腔液β-hCG/血清β-hCG的比值分组,临床追踪妊娠预后,以腹腔镜手术病理诊断或诊刮病理诊断作为明确宫内、外妊娠的依据,并将腹腔液β-hCG/血清β-hCG的比值与妊娠结局进行关联分析。结果:腹腔液β-hCG/血β-hCG比值1者均为输卵管妊娠;腹腔液β-hCG/血β-hCG比值1者均为宫内妊娠,输卵管妊娠患者腹腔液及血清E2、P值明显低于宫内妊娠者,E2、P的腹腔液与外周血比值在两组间无统计学差异。行后穹隆穿刺无一例发生感染。结论:腹腔液β-hCG/血β-hCG的比值是早期输卵管妊娠的准确诊断依据,凡腹腔液β-hCG明显高于静脉血β-hCG者为输卵管妊娠,反之为宫内妊娠,符合率为100%。
[Abstract]:Objective: to explore the method of early diagnosis of tubal pregnancy. Methods: 83 cases of suspected early ectopic pregnancy within 45 days postmenopause underwent vaginal posterior fornix puncture to obtain peritoneal fluid and quantitative determination of 尾 -hCGN E2P in peritoneal fluid and venous serum. According to the ratio of 尾 -hCG to serum 尾 -hCG in peritoneal fluid, the prognosis of pregnancy was tracked clinically, and the pathological diagnosis of intrauterine and extrauterine pregnancy was confirmed by laparoscopy. The ratio of 尾 -hCG-1 / serum 尾 -hCG in peritoneal fluid was correlated with pregnancy outcome. Results: the ratio of 尾 -hCG-1 / serum 尾 -hCG in celiac fluid was all tubal pregnancy, and 尾 -hCG-1 / 尾 -hCG ratio 1 in peritoneal fluid was intrauterine pregnancy. The ratio of peritoneal fluid to peripheral blood in patients with tubal pregnancy was significantly lower than that in patients with intrauterine pregnancy. There was no significant difference between the two groups. There was no infection in patients with posterior fornix puncture. Conclusion: 尾 -hCGs / 尾 -hCG in peritoneal fluid is significantly lower than that in patients with intrauterine pregnancy. Ratio is an accurate diagnostic basis for early tubal pregnancy. If 尾 -hCG in peritoneal fluid was significantly higher than that in venous blood, it was tubal pregnancy, whereas intrauterine pregnancy, the coincidence rate was 100%.
【作者单位】：浙江省宁海妇幼保健院;缙云县人民医院妇产科;
【基金】：浙江大学开放基金(2012RG/RH-0010) 宁波市医学科技计划(2011B19)资助项目
【分类号】：R714.221

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