摘要
目的探讨联合经会阴与经阴道超声检查对孕妇宫颈机能不全的临床价值。方法选择2015年3月至2017年3月安康市妇幼保健院诊治的42例疑似宫颈机能不全妊娠中晚期孕妇为研究对象,均采用经会阴超声检查(经会阴组)和经阴道超声检查(经阴道组),对比两种检查方法对宫颈管、宫颈内口开大程度显示情况,患者对检查方式接受率、宫颈显示满意率,并分析经会阴超声、经阴道超声、联合诊断对宫颈机能不全的诊断价值。结果经会阴组超声检查对羊膜腔向宫颈突入显示率为7.14%,与经阴道组的14.29%比较,差异无统计学意义(P>0.05);经阴道组检查对宫颈显示满意率为97.62%,明显高于经会阴组的73.81%,但患者接受率为71.43%,明显低于经会阴组的90.48%,差异均有统计学意义(P<0.05);经会阴组超声对宫颈机能不全检出率为71.43%,经阴道组超声检出率为83.33%,联合检查检出率为92.86%,联合诊断宫颈机能不全的灵敏度、特异度、阳性预测值、阴性预测值最高,分别为93.14%、90.52%、95.21%、73.65%。结论经阴道超声检查对宫颈显示率更高,但患者接受度较低,两种方法诊断宫颈机能不全均有较高价值,但联合检查可提高诊断准确率。
Objective To explore the value of combined transperineal and transvaginal ultrasonography in the diagnosis of cervical incompetence in pregnant women. Methods From March 2015 to March 2017, 42 pregnant women with suspected cervical incompetence in the second and third trimester of pregnancy, who admitted to Ankang Maternal and Child Health Hospital, were selected as the subjects. Both transperineal ultrasound and transvaginal ultrasound were used to compare the extent of cervical canal and cervical orifice enlargement, the acceptance rate of cervical examination and the rate of cervical opening, the satisfactory rate shown. The diagnostic value of transperineal ultrasound,transvaginal ultrasound and combined diagnosis for cervical incompetence was analyzed. Results Transperineal ultrasonography showed 7.14% of the amniotic cavity penetrating into the cervix versus 14.29% of transvaginal ultrasonography, there was no significant difference between transvaginal ultrasonography and transvaginal ultrasonography(P>0.05). The satisfaction rate of cervical display in the transvaginal group was significantly higher than that in the transperineal group(97.62% vs 73.81%, P<0.05), but the acceptance rate was significantly lower than that in the transperineal group(71.43% vs 90.48%, P<0.05). The detection rates of transperineal ultrasonography, transvaginal ultrasonography,and combined transperineal and transvaginal ultrasonography were 71.43%, 83.33% and 92.86% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of combined transperineal ultrasonography and transvaginal ultrasonography were 93.14%, 90.52%, 95.21% and 73.65% respectively. Conclusion Transvaginal ultrasound has a higher cervical display rate, but the patients’ acceptance is lower. Both methods have higher value in the diagnosis of cervical incompetence, but combined diagnosis can improve the accuracy of diagnosis.
作者
吴冬
黄宗华
刘佼佼
单东礼
杨斌
WU Dong;HUANG Zong-hua;LIU Jiao-jiao;SHAN Dong-li;YANG Bin(Department of Ultrasound,Ankang Maternal and Child Health Hospital,AnKang 725000,Shaanxi,CHINA;Department of Ultrasound,Shiquan County Hospital,AnKang 725200,Shaanxi,CHINA)
出处
《海南医学》
CAS
2018年第24期3494-3496,共3页
Hainan Medical Journal
基金
国家自然科学基金(编号:81172458/H1621)
关键词
经会阴超声
经阴道超声
孕妇宫颈机能不全
超声
子宫颈
Transperineal ultrasound
Transvaginal ultrasound
Pregnant women with cervical incompetence
Ultrasound
Cervix
作者简介
通讯作者:黄宗华。E—mail:sxakwjx2009@163.com
