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目的:建立并评价早期不明位置妊娠的鉴别诊断方程,对早期输卵管妊娠及早期先兆流产进行判别,指导临床治疗方案的制定。方法:通过对345例早期不明位置妊娠患者的临床资料进行回顾整理,筛选出对于输卵管妊娠及先兆流产判别有效的变量并建立贝叶斯判别方程,采用自身验证法及交互验证法进行考核验证评价。结果:筛选停经时间、不规则阴道出血、月经是否规则、自然流产史、异位妊娠史、盆腔炎史、宫内节育环、首次孕酮值、腹痛情况、首次h CG值、B超下宫旁包块、B超下盆腔积液等12个临床资料作为判别分析的变量。建立早期不明位置妊娠判别方程,包括早期先兆流产方程及早期输卵管妊娠方程。自身验证考核结果显示:先兆流产的判别正确率达98.08%,输卵管妊娠的判别正确率达93.12%,总的判别正确率达95.36%。交互验证考核结果显示:先兆流产的判别正确率达97.44%,输卵管妊娠的判别正确率达90.48%,总的判别正确率达93.62%。结论:早期不明位置妊娠的贝叶斯判别方程,能对输卵管妊娠与先兆流产进行早期判别,可为不明位置妊娠的早期临床诊断及确定有效的治疗方案提供临床参考。
OBJECTIVE: To establish and evaluate the differential diagnosis equation of early unknown pregnancy, to distinguish early tubal pregnancy and early threatened abortion, and to guide the formulation of clinical treatment plan. Methods: The clinical data of 345 patients with unknown early stage pregnancy were reviewed and sorted out, and the variables valid for tubal pregnancy and threatened abortion were screened out. The Bayesian discriminant equation was established. The self-validation and cross-validation were used to verify the assessment . Results: The screening of menopause time, irregular vaginal bleeding, menstrual rules, spontaneous abortion history, history of ectopic pregnancy, history of pelvic inflammatory disease, intrauterine contraceptive ring, the first progesterone value, abdominal pain, the first hCG value, B- Next mass, B ultra-pelvic fluid and other 12 clinical data as a discriminant analysis of variables. Establishment of early pregnancy discriminant location of unknown location, including early threatened abortion equation and early tubal pregnancy equation. The results of self-assessment showed that the correct rate of diagnosis of threatened abortion was 98.08%, the correct rate of tubal pregnancy was 93.12%, and the total correct rate was 95.36%. The results of cross-validation test showed that the accuracy rate of threatened abortion was 97.44%, the correct rate of tubal pregnancy was 90.48%, and the correct rate was 93.62%. Conclusion: Bayesian discriminant equation of early unknown pregnancy can make early diagnosis of tubal pregnancy and threatened abortion, which can provide clinical reference for early clinical diagnosis of unknown pregnancy and effective treatment.