彩色多普勒超声测子宫内膜厚度与血清β-HCG联合检测对早期异位妊娠的诊断价值

发布时间：2018-08-29 19:37

【摘要】：目的：从循证医学角度将生化学指标（血清β-HCG）与影像学指标（彩色多普勒超声测量子宫内膜厚度）结合起来，评价其在异位妊娠中的诊断价值。方法：对吉林大学第一附属医院于2010年1月1日至2012年7月1日期间到妇科就诊的、孕周为5-7周、疑似异位妊娠的358例患者的临床资料进行分析，并应用SASS9.0软件进行统计学分析。结果：本组资料中，患者年龄17-45岁,平均29.47±6.68岁，，平均孕周5.57±0.55周，经手术、病理、彩色多普勒超声检查和血清β-HCG检测的方法确诊正常妊娠患者80例，自然流产患者82例，异位妊娠患者196例。妊娠的周数比较，即正常妊娠组（6.02±0.36），妊娠流产组(5.81±0.34)与异位妊娠组（5.27±0.49），三者比较无统计学意义（p0.05）。在相同条件下（妊娠5-7周），正常妊娠组血清β-HCG值（1252.07±189.0IU/L）明显高于妊娠流产组（900.50±192.22IU/L）及异位妊娠组（824.63±229.02IU/L），该差异有统计学意义（p㩳0.05），而流产妊娠组与异位妊娠组相比差异无统计学意义（p㧐0.05）。彩色多普勒超声下诊断子宫内膜厚度显示，正常妊娠组（11.33±0.77mm）大于妊娠流产组（7.93±1.22mm）及异位妊娠组（6.69±1.49mm）（p㩳0.05），但后两者相比差异无统计学意义（p㧐0.05）。单独检测血清人绒毛膜促性腺激素结果检出率为45.9%，单独检查彩色多普勒超声下子宫内膜厚度结果符合率为51.0%，二者联合检测诊断符合率为98%（p㩳0.05），各种检查在诊断异位中的特异性和敏感性忽略不计。结论：众多辅助方法之中，以影像学指标作为首选，因其可以直观检测；如结合血清人绒毛膜促性腺激素（血清β-HCG值）能更有效诊断异位妊娠。
[Abstract]:Objective: to evaluate the diagnostic value of biochemical index (serum 尾 -HCG) and imaging index (color Doppler ultrasound for endometrial thickness) in ectopic pregnancy from the perspective of evidence-based medicine. Methods: the clinical data of 358 patients with suspected ectopic pregnancy from January 1, 2010 to July 1, 2012 in the first affiliated Hospital of Jilin University were analyzed. SASS9.0 software was used for statistical analysis. Results: the age of the patients was 17-45 years old (mean 29.47 卤6.68 years, mean gestational age 5.57 卤0.55 weeks). 80 cases of normal pregnancy and 82 cases of spontaneous abortion were confirmed by operation, pathology, color Doppler ultrasound and serum 尾 -HCG. 196 cases of ectopic pregnancy. The number of weeks of pregnancy was (6.02 卤0.36) in normal pregnancy group, (5.81 卤0.34) in abortion group and (5.27 卤0.49) in ectopic pregnancy group. There was no significant difference among the three groups (p0.05). Under the same condition (5-7 weeks of pregnancy), the serum 尾 -HCG level in normal pregnancy group (1252.07 卤189.0IU/L) was significantly higher than that in abortion group (900.50 卤192.22IU/L) and ectopic pregnancy group (824.63 卤229.02IU/L), but there was no significant difference between abortion group and ectopic pregnancy group (p0.05). The thickness of endometrium in normal pregnancy group (11.33 卤0.77mm) was higher than that in normal pregnancy group (7.93 卤1.22mm) and ectopic pregnancy group (6.69 卤1.49mm), but there was no significant difference between the latter two groups. The detection rate of serum human chorionic gonadotropin alone was 45.9. The coincidence rate of endometrial thickness under color Doppler ultrasound was 51.0. The diagnostic coincidence rate of the two combined detection was 98% (p0.05). The specificity and sensitivity were ignored. Conclusion: among the many auxiliary methods, imaging index is the first choice because it can be detected directly, such as serum human chorionic gonadotropin (serum 尾 -HCG) can be used to diagnose ectopic pregnancy more effectively.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.22;R445.1

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