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目的分析经阴道超声检查在输卵管妊娠与妊娠黄体囊肿鉴别诊断中的价值,以期发掘有利于鉴别诊断的超声学指标。方法选取2012年1月-2017年1月在常州市第二人民医院接受诊疗的输卵管妊娠患者49例为观察组,另选取同期在该院接受诊疗的妊娠卵巢黄体囊肿患者51例为对照组。两组患者均采用经阴道彩色多普勒超声检查,取旁观截石位检查并对比两组包块相关超声参数及血流动力学参数。对比改变体位后包块与同侧卵巢的相对位置改变情况。结果观察组患者包块的平均直径及环壁厚度与对照组比较,差异无统计学意义(P>0.05)。观察组患者包块高回声和不均质包块比例显著高于对照组,差异有统计学意义(P<0.01)。观察组患者包块血流分布以点/线状居多,对照组患者包块血流分布以环形居多,两组患者包块血流分布比较,差异有统计学意义(P<0.01)。观察组患者平均动脉收缩期峰值流速显著低于对照组,而血流阻力指数显著高于对照组患者,差异有统计学意义(P<0.05)。观察组更换体位后包块相对位置改变率显著高于对照组,差异有统计学意义(P<0.01)。结论经阴道超声检查对鉴别输卵管妊娠与妊娠黄体囊肿有明确价值,其中变换体位后包块与卵巢的相对位置改变、包块点/线状血流分布等为输卵管妊娠较为特异的超声表现。
Objective To analyze the value of transvaginal ultrasonography in the differential diagnosis of tubal pregnancy and pregnancy luteal cyst in order to explore the ultrasonic diagnostic index. Methods From January 2012 to January 2017, 49 patients with tubal pregnancy treated in Changzhou Second People’s Hospital were selected as the observation group. Another 51 patients with ovarian luteal cyst in the same period were selected as the control group. Transvaginal color Doppler ultrasonography was performed in both groups, and the lithotomy position was examined. The relative ultrasound parameters and hemodynamic parameters of two groups were compared. Comparison of post-parcel and ipsilateral ovarian relative position changes. Results The mean diameter of the mass in the observation group and the thickness of the annular wall were not significantly different from those in the control group (P> 0.05). The proportion of hyperechoic and inhomogeneous masses in the observation group was significantly higher than that in the control group, with significant difference (P <0.01). The distribution of blood flow in the observation group was mostly in point / line. The distribution of blood flow in the control group was mostly in the ring. The distribution of blood flow in the two groups was statistically significant (P <0.01). The peak mean arterial systolic velocity of the observation group was significantly lower than that of the control group, while the blood flow resistance index was significantly higher than that of the control group (P <0.05). The change rate of the relative position of the mass in the observation group after replacement was significantly higher than that in the control group, with a significant difference (P <0.01). Conclusion Transvaginal ultrasonography has clear value in differential diagnosis of tubal pregnancy and pregnancy, including the change of relative position of mass and ovary, and the distribution of mass spot / linear blood flow in tubal pregnancy.