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目的:比较阴道超声(TVS)与腹部超声(TAS)检查在诊断异位妊娠(EP)中的临床价值。方法:选择经手术和病理检查确诊的EP 65例,术前均行TVS和TAS检查,观察子宫大小、宫腔内妊娠囊情况、盆腔内是否存在无回声区及有无腹水、双附件、子宫直肠陷凹是否存在异常包块等。比较两种超声检查方法对EP的诊断情况及其声像图表现。结果:(1)本组65例中,TVS检出输卵管妊娠、阔韧带妊娠、卵巢妊娠、宫角妊娠共64例,符合率98.5%;TAS检出输卵管妊娠、阔韧带妊娠、卵巢妊娠、宫角妊娠共59例,符合率90.8%;TVS诊断符合率显著高于TAS(P<0.05)。(2)TVS检查在宫外类孕囊影、宫外混合性团块影、宫外类孕囊影中可显示胚芽及胎心、可见原始心管搏动等声像图显示方面,均显著或非常显著优于TAS检查(P<0.05,P<0.01);两种检查方法在子宫直肠陷凹积液显示方面比较,差异不显著(P>0.05)。结论:TVS检查在EP诊断的准确率和声像图表现方面优于TAS检查。
Objective: To compare the clinical value of transvaginal sonography (TVS) and abdominal ultrasonography (TAS) in the diagnosis of ectopic pregnancy (EP). Methods: Totally 65 patients with EP confirmed by operation and pathology were examined by TVS and TAS before operation. The size of uterus, intrauterine gestational sac, pelvic echo-free zone, ascites, double attachments, uterus Rectal potholes there is abnormal mass and so on. Comparison of two kinds of ultrasound examination of the diagnosis of EP and its sonographic performance. Results: (1) In this group of 65 cases, TVS detected tubal pregnancy, broad ligament pregnancy, ovarian pregnancy, uterine horn pregnancy a total of 64 cases, with a coincidence rate of 98.5%; TAS tubal pregnancy, broad ligament pregnancy, ovarian pregnancy, A total of 59 cases of pregnancy angle, the coincidence rate of 90.8%; TVS diagnostic coincidence rate was significantly higher than TAS (P <0.05). (2) TVS examination of extrauterine gestational sac shadow, extrauterine mixed mass shadow, extrauterine gestational sac shadow can show the embryo and fetal heart rate, showing the original cardiac beat and other sonographic display, were significant or (P <0.05, P <0.01). There was no significant difference between the two methods in the display of uterine rectocele (P> 0.05). Conclusions: TVS is superior to TAS in terms of diagnostic accuracy and sonographic findings of EP.