摘要
目的 探讨基于经腹部及阴道超声联合应用在妇科急腹症中的诊断价值分析.方法 选取2021年1月至2024年1月本院收治的疑似妇科急腹症患者206例为研究对象,均行经腹部及阴道超声检查,以手术病理、随访结果为"金标准",比较经腹部及阴道超声检查单项或二者联合应用对妇科急腹症的诊断价值.结果 以手术病理、随访结果为"金标准",纳入的206例疑似妇科急腹症患者中,确诊病例为154例,其中异位妊娠、黄体破裂、急性盆腔炎、急性子宫穿孔分别占比为44.2％(68/154)、26.0％(40/154)、19.5％(30/154)、10.4％(16/154).基于经腹部及阴道超声联合检查对妇科急腹症的诊断灵敏度、特异度、阳性预测值、阴性预测值以及准确率分别为 94.2％(145/154)、94.2％(49/52)、98.0％(145/148)、84.5％(49/58)、94.2％(194/206),均高于单独腹部超声检查 72.7％(112/154)、73.1％(38/52)、88.9％(112/126)、47.5％(38/80)、72.8％(150/206)和阴道超声检查 81.8％(126/154)、76.9％(40/52)、91.3％(126/138)、58.8％(40/68)、80.6％(166/206)(x2=25.133,P＜0.001;x2=8.726,P=0.014,x2=9.454,P=0.009;x-19.794,P＜0.001;x2=33.391,P＜0.001).基于经腹部及阴道超声联合检查对异位妊娠、黄体破裂的检出率分别为91.2％(62/68)、95.0％(38/40),均高于单独腹部超声检查67.7％(46/68)、72.5％(29/40)和阴道超声检查 85.3％(58/68)、75.0％(30/40)(x=13.453,P=0.001;x2=7.853,P=0.020);基于经腹部及阴道超声单独、联合应用对急性盆腔炎、急性子宫穿孔以及卵巢囊肿蒂扭转的检出率比较差异无统计学意义(P＞0.05).结论 基于经腹部及阴道超声联合应用能提高妇科急腹症的诊断效能.
Abstract
Objective To explore the diagnostic value of combined application of transabdominal and vaginal ultrasound in gynecological acute abdomen.Methods A total of 206 patients with suspected gynecological acute abdomen admitted to our hospital from January 2021 to January 2024 were selected as the study subjects.All patients underwent transabdominal and vaginal ultrasonography.With surgical pathology and follow-up results as the"gold standard",the diagnostic value of single or combined application of transabdominal and vaginal ultrasonography in gynecological acute abdomen was compared.Results With surgical pathology and follow-up results as the"gold standard",154 cases were confirmed among 206 suspected gynecological acute abdomen patients,of which ectopic pregnancy,corpus luteum rupture,acute pelvic inflammatory disease and acute uterine perforation accounted for 44.2％(68/1 54),26.0％(40/154),19.5％(30/1 54)and 10.4％(16/154),respectively.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of combined transabdominal and vaginal ultrasonography for gynecological acute abdomen were 94.2％(145/154),94.2％(49/52),98.0％(145/148),84.5％(45/58)and 94.2％(194/206),respectively.The results were higher than those of abdominal ultrasound alone[72.7％(112/154),73.1％(38/52),88.9％(112/126),47.5％(38/80),72.8％(150/206)]and vaginal ultrasound alone[81.8％(126/154),76.9％(40/52),91.3％(126/138),58.8％(40/68),80.6％(166/206)](x2=25.133,P＜0.001;x2=8.726,P=0.014,x2=9.454,P=0.009;x2=19.794,P＜0.001;x2=33.391,P＜0.001).The detection rates of ectopic pregnancy and corpus luteum rupture based on combined abdominal and vaginal ultrasonography were 91.2％(62/68)and 95.0％(38/40),respectively,higher than those of abdominal ultrasonography alone[67.7％(46/68),72.5％(29/40)]and vaginal ultrasonography alone[85.3％(58/68),75.0％(30/40)](x2=13.453,P=0.001;x2=7.853,P=0.020).The detection rates of acute pelvic inflammatory disease,acute uterine perforation and pedicle torsion of ovarian cyst were compared based on transabdominal and vaginal ultrasound alone and combined application.Conclusion The combined application of transabdominal and vaginal ultrasound can improve the diagnostic efficiency of gynecological acute abdomen.
维普
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