彩色多普勒超声对宫内宫外复合妊娠的诊断价值

发布时间：2018-11-20 13:09

【摘要】：目的探讨彩色多普勒超声在宫内宫外复合妊娠中的诊断价值。方法回顾性分析经手术病理证实的15例宫内宫外复合妊娠的二维及彩色多普勒声像图特征、临床表现、受孕方式及患者血β-HCG的水平。结果 (1)宫内宫外复合妊娠宫外孕易发生于输卵管;(2)受孕方式与促排卵药物的应用、体外受精-胚胎移植相关;(3)患者血β-HCG水平多数增高;(4)声像图表现为直接征像和间接征像;直接征像为:宫腔内、宫腔外均有妊娠囊,囊内可见卵黄囊和或胚芽;间接征像为:宫腔内间接征像包括宫内小暗区,伴有周边回声增强和可见血流信号;宫外间接征像包括附件包块和盆腔积液。本组超声正确诊断13例,漏、误诊2例。结论宫内宫外复合妊娠易漏、误诊,在超声诊断中应密切结合病史,同时联系血β-HCG水平,可以提高宫内宫外复合妊娠诊断的正确率,对临床的早期诊断、早期治疗提供及时有效的帮助。
[Abstract]:Objective to evaluate the diagnostic value of color Doppler ultrasound in intrauterine and extrauterine pregnancy. Methods two dimensional and color Doppler sonographic features, clinical manifestations, pregnancy patterns and serum 尾-HCG levels of 15 cases of intrauterine complex pregnancy confirmed by surgery and pathology were retrospectively analyzed. Results (1) ectopic pregnancy was prone to occur in fallopian tubes, (2) pregnancy mode was related to the use of ovulation stimulating drugs, and in vitro fertilization and embryo transfer, (3) the serum 尾-HCG level was increased in most of the patients. (4) the direct and indirect signs of sonography were as follows: there were pregnancy sac in uterine cavity and outside uterine cavity, yolk sac and embryo bud could be seen in the cyst; The indirect signs included intrauterine small dark areas with enhanced peripheral echo and visible blood flow signals, and extrauterine indirect signs included adnexal masses and pelvic effusion. 13 cases were diagnosed correctly by ultrasonography, 2 cases were misdiagnosed. Conclusion combined intrauterine and extrauterine pregnancy is easy to leak and misdiagnosed, so it should be combined closely with the history of ultrasound diagnosis and blood 尾-HCG level, which can improve the accuracy of intrauterine and extrauterine pregnancy diagnosis and early clinical diagnosis. Early treatment provides timely and effective help.
【作者单位】：包头医学院第一附属医院;
【分类号】：R445.1;R714.22

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