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腹部超声联合阴道超声在妇科急腹症患者中的诊断效果及鉴别价值研究

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目的:研究腹部超声联合阴道超声在妇科急腹症患者中的诊断效果及鉴别价值。方法:回顾性分析2022年1月—2024年1月都江堰市第二人民医院的120例高度疑似妇科急腹症患者资料,所有患者均接受腹部超声检查、阴道超声检查及联合检查(腹部超声联合阴道超声检查)。以病理检查结果作为金标准,分析3种不同检查方式的临床诊断效果。结果:120例高度疑似妇科急腹症患者的病理检查结果显示阳性 88例,其中包括异位妊娠 30例、急性盆腔炎 16例、卵巢囊肿蒂扭转22例、黄体破裂 20 例;阴性 32例,其中包括急性腹痛 22例、急性阑尾炎 10例。腹部超声检查结果显示阳性 70例、阴性50例,灵敏度、特异性、准确性、误诊率、漏诊率、阳性预测值、阴性预测值分别为 68。18%、68。75%、68。33%、31。25%、31。82%、85。71%、44。00%。阴道超声检查结果显示阳性76例、阴性44例,灵敏度、特异性、准确性、误诊率、漏诊率、阳性预测值、阴性预测值分别为 78。41%、78。13%、78。33%、21。88%、21。59%、90。79%、56。82%。联合检查结果显示阳性 87例、33例阴性,灵敏度、特异性、准确性、误诊率、漏诊率、阳性预测值、阴性预测值分别为 97。73%、96。88%、97。50%、3。13%、2。27%、98。85%、93。94%。联合检查的灵敏度、特异性、准确性、阳性预测值、阴性预测值均高于单一腹部超声检查、单一阴道超声检查,联合检查的误诊率、漏诊率均低于单一腹部超声检查、单一阴道超声检查,差异均有统计学意义(P<0。05)。联合检查阳性患者的鉴别诊断中,检出异位妊娠 30例、急性盆腔炎 16例、卵巢囊肿蒂扭转 22例、黄体破裂 20例,其与金标准阳性鉴别诊断相比,准确性分别为 100。00%(30/30)、93。75%(15/16)、100。00%(22/22)、100。00%(20/20)。结论:腹部超声联合阴道超声在诊断和鉴别妇科急腹症患者中的临床价值高于单一腹部超声检查和单一阴道超声检查,具有重要的临床应用意义。
Study on the Diagnostic Effect and Differential Value of Abdominal Ultrasonography Combined with Vaginal Ultrasonography in Patients with Gynecological Acute Abdomen
Objective:To investigate the diagnostic effect and differential value of abdominal ultrasonography combined with vaginal ultrasonography in patients with gynecological acute abdomen.Methods:Data of 120 patients with highly suspected gynecological acute abdomen in the Dujiangyan Second People's Hospital from January 2022 to January 2024 were retrospectively analysed.All patients underwent abdominal ultrasonography,vaginal ultrasonography and combined examination(abdominal ultrasonography combined with vaginal ultrasonography).The results of pathological examination were used as the gold standard to analyze the clinical diagnosis effect of 3 different examination methods.Results:A total of 88 cases of 120 patients with highly suspected gynecological acute abdomen were positive,including 30 cases of ectopic pregnancy,16 cases of acute pelvic inflammation,22 cases of torsion of ovarian cyst and 20 cases of corpus luteum rupture;32 cases were negative,including 22 acute abdominal pain and 10 acute appendicitis.The results of abdominal ultrasonography showed 70 positive cases and 50 negative cases,the sensitivity,specificity,accuracy,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value were 68.18%,68.75%,68.33%,31.25%,31.82%,85.71%and 44.00%,respectively.The results of vaginal ultrasonography showed 76 positive cases and 44 negative cases,the sensitivity,specificity,accuracy,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value were 78.41%,78.13%,78.33%,21.88%,21.59%,90.79%and 56.82%,respectively.The results of joint examination showed that 87 cases were positive and 33 cases were negative,the sensitivity,specificity,accuracy,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value were 97.73%,96.88%,97.50%,3.13%,2.27%,98.85%and 93.94%,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of combined examination were higher than those of single abdominal ultrasound and single vaginal ultrasound,and the misdiagnosis rate and missed diagnosis rate of combined examination were lower than that of single abdominal ultrasound and single vaginal ultrasound,with statistical significance(P<0.05).In the differential diagnosis of patients with positive combined examination,30 cases of ectopic pregnancy,16 cases of acute pelvic inflammatory disease,22 cases of torsion of ovarian cyst and 20 cases of luteal rupture were detected,the accuracy was 100.00%(30/30),93.75%(15/16),100.00%(22/22),100.00%(20/20),respectively.Conclusion:Abdominal ultrasonography combined with vaginal ultrasonography is more valuable than single abdominal ultrasonography and single vaginal ultrasonography in diagnosing and differentiating patients with gynecological acute abdomen,and has important clinical significance.

Gynecological acute abdomenAbdominal ultrasoundVaginal ultrasoundDiagnostic effectDifferential value

鲁国艳

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四川省都江堰市第二人民医院功能科,都江堰 611830

妇科急腹症 腹部超声 阴道超声 诊断效果 鉴别价值

2024

中国伤残医学
中国康复医学会,黑龙江省截瘫研究所

中国伤残医学

影响因子:0.451
ISSN:1673-6567
年,卷(期):2024.32(14)