经阴道彩超在子宫瘢痕处早期妊娠诊断中的应用

目的：探讨经阴道彩色多普勒超声（彩超）在子宫瘢痕处早期妊娠诊断中的应用价值。方法：研究对象为2011年2月．2012年2月我院接诊的26例经手术或病理确诊的子宫瘢痕处早期妊娠患者,回顾性总结了26例患者的经腹及经彩超资料。结果：通过经阴道彩超的图像声像图分析,及其与手术中病理确诊对比。经阴道彩超诊断符合率（96．1％）显著高于经腹部彩超检查诊断符合率（73．1％）（P〈0．05）。从声像图可以将其分为三型,分别为孕囊型、不均质包快型和混合型。其声像图有各自独特的表现,主要区别在于子宫前壁的下段的表现,及周围血流信号的不同。结论：与经腹壁超声相比,经阴道彩超避免了腹部器官的影响,做到无创,快捷,方便,对子宫瘢痕处早期妊娠的诊断有较高的应用价值,值得推广应用。     

经阴道彩超联合腹部超声在异位妊娠中的诊治分析

目的：与经阴道彩超检查相比较探讨经阴道彩超联合腹部超声检查在异位妊娠中的诊治价值。方法：选取我院2009 年3月至2012 年12 月之间诊治的136 例疑为异位妊娠患者,其中70 例经阴道彩超联合腹部超声诊断,66 例经阴道彩超诊断,采用SPSS13.0 统计学软件对数据进行统计学分析,所有计数资料均行x2检验,以P〈0.05 为差异有统计学意义。结果：在70 例经阴道彩超联合腹部超声检查的病例中,有68 人与手术结果相符合,诊断符合率达97.10%,1 例误诊,1 例漏诊;在另外66 例经阴道彩超检查患者中,有59例与手术结果相符合,诊断符合率为89.40%,6 例误诊,1 例漏诊。结论：经阴道彩超与经腹部超声的联合相对于经阴道彩超而言,诊断的准确率有所提高,决定这一结果的关键因素在于腹部超声减少了误诊例数。     

经阴道彩超联合腹部超声在异位妊娠中的诊治分析 *

摘要 目的： 与经阴道彩超检查相比较探讨经阴道彩超联合腹部超声检查在异位妊娠中的诊治价值。方法： 选取我院 2009 年 3 月 至 2012 年 12 月之间诊治的 136 例疑为异位妊娠患者,其中 70 例经阴道彩超联合腹部超声诊断, 66 例经阴道彩超诊断,采用 SPSS13.0 统计学软件对数据进行统计学分析, 所有计数资料均行 x 2 检验,以 P<0.05 为差异有统计学意义。结果： 在 70 例经阴道 彩超联合腹部超声检查的病例中, 有 68 人与手术结果相符合, 诊断符合率达 97.10%, 1 例误诊, 1 例漏诊; 在另外 66 例经阴道彩 超检查患者中, 有 59 例与手术结果相符合, 诊断符合率为 89.40%, 6 例误诊, 1 例漏诊。 结论： 经阴道彩超与经腹部超声的联合 相对于经阴道彩超而言, 诊断的准确率有所提高, 决定这一结果的关键因素在于腹部超声减少了误诊例数。 关键词：     

经腹和阴道超声诊断输卵管妊娠的临床价值

目的观察比较经腹和阴道超声诊断输卵管妊娠的临床价值。方法选取我院收治的经手术病理证实输卵管妊娠患者81例为研究对象,术前分别行经腹超声和阴道超声检查诊断,并对两种检查方法的应用价值进行分析比较。结果经阴道超声检查,子宫增大、假孕囊、内膜增强增粗、类妊娠囊结构、附件包块、胚胎心血管搏动检出率均明显高于经腹超声(P0.05);经阴道超声检查的灵敏度、准确率明显高于经腹超声检查(P0.05)。结论经阴道超声诊断输卵管妊娠的临床价值明显优于经腹超声,值得推广。     

早期异位妊娠诊断中腹部彩超和阴道彩超的临床应用

目的对应用经腹部彩超和经阴道彩超两种技术对早期异位妊娠疾病进行诊断的临床价值进行研究。方法选择在我院就诊的病理学确诊为早期异位妊娠疾病的患者82例,随机分为对照组和研究组,平均每组41例。采用经腹部彩超技术对对照组患者病情进行诊断;采用经阴道彩超技术对研究组患者病情进行诊断。结果研究组患者早期异位妊娠疾病诊断结果与病理学结果符合率明显高于对照组,组间差异显著(P0.05);漏诊和误诊率明显低于对照组,组间差异显著(P0.05)。结论与腹部彩超技术比较,在早期异位妊娠疾病的诊断方面,经阴道彩超技术具有明显的优势。     

经阴道彩色多普勒超声诊断异位妊娠的临床价值分析

目的:探讨经阴道彩色多普勒超声诊断用于诊断异位妊娠的检出率与准确率,为其临床应用提供参考。方法:选取2016年1月-2017年12月我院收治的疑似异位妊娠患者174例,依据随机数字表方法将其分为观察组和参考组,每组87例。参考组应用经腹部彩色多普勒超声予以诊断,观察组采用经阴道彩色多普勒超声进行诊断,比较两组的检出率与准确率。结果:观察组检出率为96.5%,明显高于参考组(86.2%,P0.05);观察组的准确率达97.6%,明显高于参考组(85.7%,P0.05)。在对大病灶的诊断中,两组的诊断准确率比较差异无统计学意义(P0.05);在小病灶诊断中,观察组的诊断准确率为97.6%,明显高于参考组(76.9%,P0.05)。观察组在胎囊型和飘浮型中的诊断率均明显的高于参考组(P0.05);在包块型的诊断中,两组诊断准确率比较差异无统计学意义(P0.05)。结论:与经腹部彩色多普勒超声相比,经阴道彩色多普勒超声诊断应用于异位妊娠中具有较高的检出率与准确率,尤其针对一些较小的病灶诊断有优势。     

经阴道超声诊断妇科宫腔疾病的作用分析

目的探讨经阴道超声诊断妇科宫腔疾病的作用价值。方法选取2018年3月～2019年3月我院妇科收治的244例疑似子宫病变患者,分别经腹部、阴道行超声检查,并与病理诊断结果进行对照比较腹部超声、阴道超声的诊断准确率。结果在244例疑似病变中,经阴道超声检查,共检出子宫内膜癌3例、子宫内膜息肉9例、黏膜下肌瘤9例、子宫内膜增厚29例;经腹部超声检查,分别检出子宫内膜息肉3例、黏膜下肌瘤2例、子宫内膜增厚24例。以病理结果为金标准,经阴道超声检查的准确度为92.59%,而经腹部超声检查的准确度为53.70%,经阴道超声检查的准确度明显高于经腹部超声,差异有统计学意义(P0.05)。结论经阴道超声在妇科宫腔疾病的诊断准确率显著高于腹部超声,具有临床应用价值。     

经阴道超声与宫腔镜对子宫内膜病变患者的诊断价值比较研究

目的:探讨经阴道超声与宫腔镜检查诊断子宫内膜病变的临床价值,为临床诊断子宫内膜病变提供理论依据。方法:选取2011年3月-2014年3月间我院收治的158例疑似子宫内膜病变患者,分别采用经阴道超声和宫腔镜进行检查,并以病理诊断结果为"金标准",比较两种检查方法的诊断价值。结果:病理检查结果中,143例患者被确诊为子宫内膜病变,其中子宫内膜增生23例(16.08%),子宫内膜息肉31例(21.68%),子宫粘膜下肌瘤24例(16.78%),子宫内膜癌19例(13.29%),慢性非特异性子宫内膜炎46例(32.17%)。宫腔镜对子宫内膜病变诊断的准确率为94.41%,高于阴道超声的81.12%,差异有统计学意义(P0.05),其中阴道超声和宫腔镜对子宫粘膜下肌瘤、子宫内膜癌诊断的准确率比较差异无统计学意义(P0.05),阴道超声对子宫内膜增生、子宫内膜息肉及慢性非特异性子宫内膜炎的诊断准确率均较宫腔镜降低,差异有统计学意义(P0.05)。阴道超声对子宫内膜病变诊断的特异度较宫腔镜更低(P0.05),但两者灵敏度、AUC比较差异无统计学意义(P0.05)。结论:经阴道超声诊断子宫内膜病变简单、有效,而宫腔镜诊断子宫内膜病变具有准确率以及特异度较高的特点。     

分析急性阑尾炎不同病理类型的超声图像特征

目的:探究急性阑尾炎不同病理类型的超声图像特征。方法:选取我院2012年11月~2014年11月收治的急性阑尾炎患者100例为研究对象,所有患者均利用彩色多普勒超声诊断仪进行诊断,将诊断结果与患者的病理诊断结果进行对比。结果:经彩超诊断,100例患者中急性阑尾炎患者68例;全腹肠腔积液患者20例;正常12例。若按不同病理类型分型,急性化脓性阑尾炎患者32例,慢性阑尾炎急性发作30例,急性蜂窝组织性阑尾炎患者20例,急性单纯性阑尾炎患者12例,急性坏疽性阑尾炎6例。结论:给予急性阑尾炎患者超声诊断,能有效提高诊断准确率,并能对阑尾炎的分型与病程做出正确判断,值得临床推广使用。     

超声引导下经阴道细针穿刺注射5-FU治疗宫外孕的疗效观察

目的：探讨超声引导下经阴道应用细针穿刺注射5-FU介入治疗异位妊娠的临床疗效。方法：超声引导下经阴道用18G及22GPTC针对42例未破裂型异位妊娠病灶进行穿刺抽吸囊液后,注射5．氟尿嘧啶（5-FU）及氨甲喋呤（MTX）治疗,进行疗效观察。结果：应用22G细针穿刺,一次性穿刺成功病例21例,成功率100％;穿刺出血病例3例,穿刺后出血发生率14．2％。对照组18G粗针穿刺,分别为15例、71．4％;9例、42．8％;差异具有显著性（P〈0．05）。注射5-FU术1周病人血HCG测量值及异位妊娠病灶缩小或消失率达到90．4％、治疗方法有效率为95．2％,对照组注射MTX分别为71．4％、80．9％;差异具有显著性（P〈0．05）。结论：超声引导下经阴道22G细针穿刺注射5．Fu治疗未破裂型宫外孕较18G粗针及注射MIX疗效显著,成功率高、副反应少,为临床保守治疗未破裂型异位妊娠穿刺针型号及用药种类的选择提供了一种新的方法,有一定的临床应用价值。     

Performance et vulgarisation de l’écho-Doppler par couplage sus-pubien et endovaginal dans le diagnostic précoce des grossesses extra-utérines en Côte d’Ivoire

ObjectiveThe aim of our study was to describe the epidemiological profile of ectopic pregnancies (EP) in Côte d’Ivoire and to show the utility of ultrasound Doppler in the early diagnosis of EP.Patients and methodOur prospective study had been carried out for 24 months (from February 2006 to January 2008). It concerned 32 cases of ectopic pregnancy discovered at the suprapubic or endovaginal ultrasound scan with or without Doppler use.ResultsThe frequency of ectopic pregnancies was estimated at 1.7%. Patients’ mean age was 26.2 years. The personal history was dominated by abortions (32%) and adnexal infections (20%). Most of the patients were nulliparous (52.5%). Requests for ultrasound scans were motivated for most of them by metrorrhagia. The ectopic pregnancy was diagnosed at the ruptured stage in 65.6% of the cases (21 patients) and at the nonruptured stage in 34.4 % of the cases (11 patients). In six cases of nonruptured stage, we used the Doppler. The elementary lesions found were hematosalpinx in 40.6% of the cases, embryonate ectopic gestational sac (31.3%) and nonembryonate ectopic gestational sac (18.7%). In three cases (9.4%), no elementary lesions were found.Conclusionin Côte d’Ivoire, the ectopic pregnancy concerns a very young nulliparous population with abortion and adnexal history. The use of color signal of Doppler added to the endovaginal ultrasound scan, allows establishing the diagnosis at the early stage.     

对比分析四维容积超声及彩色多普勒超声在胎儿肺静脉异位引流诊断中的应用

摘要 目的：对比分析四维容积超声及彩色多普勒超声在胎儿肺静脉异位引流（APVC）诊断中的应用价值。方法：采用回顾性分析方法,2019年1月到2022年1月选择在本院进行诊治的胎儿肺静脉异位引流孕妇60例作为研究对象,都给予四维容积超声及彩色多普勒超声,记录影像学特征并判断诊断价值。结果：在60例孕妇中,彩色多普勒超声检查判断为胎儿肺静脉异位引流51例,诊断敏感性为85.0 %;四维容积超声检查判断为胎儿肺静脉异位引流59例,诊断敏感性为98.3 %,四维容积超声检查对胎儿肺静脉异位引流的诊断敏感性明显高于彩色多普勒超声检查（P<0.05）。彩色多普勒超声检查与四维容积超声检查诊断的特异性都为100.0%。在60例孕妇中,判断为胎儿肺静脉异位引流心上型32例,心下型28例;心上型的肺静脉引流途径为肺静脉-垂直静脉-右上腔静脉22例、肺静脉-垂直静脉-左上腔静脉10例,心下型的肺静脉引流途径为肺静脉-垂直静脉-左头臂静脉-右上腔静脉6例、肺静脉-垂直静脉-门静脉22例。合并心脏畸形32例,合并畸形率为53.3 %;有51例孕妇终止妊娠,9例孕妇继续妊娠,其中8例未经治疗者新生儿期死亡,1例在3月龄死亡。结论：相对于彩色多普勒超声,四维容积超声在胎儿肺静脉异位引流诊断中的应用可提高诊断敏感性,可有效反映肺静脉回流情况,可指导临床进行早期干预。     

Abdominal pregnancy in a baboon: a first case report

The abdominal pregnancy is a rare, but life threatening complication of ectopic embryo implantation. Only three cases of abdominal pregnancy have been previously described in primates: in a squirrel monkey, owl monkey and in a rhesus macaque. A 14-year-old wild-caught olive baboon (Papio cynocephalus anubis) was diagnosed at the ultrasound examination with advanced gestational age extrauterine pregnancy. At the initial laparotomy and necropsy the diagnosis of abdominal pregnancy was made on Studdiford's criteria. This case indicates the possibility of developing a model for further study of different types of ectopic pregnancy and indicates a cesarean section as a risk factor for abdominal pregnancy.     

Early diagnosis and treatment of ectopic pregnancy

During the period from 1995 to 1999, 64 patients were treated for ectopic pregnancy. All patients admitted to the department passed the same procedure including (complete preoperative laboratory findings, Beta HCG, serum progesterone and transvaginal colour Doppler). In patients who had ultrasound finding typical for ectopic pregnancy in combination with positive Beta HCG, conservative treatment was primarily done. In the rest of the patients, Beta HCG was tested every second day and in combination with the clinical and vaginosonographical findings the patients underwent diagnostic or operative laparoscopy. Out of 64 patients 36 had visible ectopic pregnancy when admitted to the clinical department. Three patients had no visible ectopic pregnancy neither at the time of their admission to the department nor at the time of laparoscopy. One of them had cervical pregnancy and the other two had pregnancies in the uterine part of the tube. The patient with cervical pregnancy was treated with metrotrexat (MTX) 12 mg daily in 5 doses. One patient with cornual pregnancy was treated with high doses of oxytocin infusion in combination with MEB intravenously 3 x 1 amp. The other patient with cornual pregnancy underwent laparoscopy with cornual resection and salpingectomy. Four of other tubar pregnancies were treated with metrotrexat 12 mg/day for 5 days. Other ectopic pregnancies were treated as follows: 36 laparoscopic salpingectomies, 10 laparoscopic salpingotomies with ovum expression, 9 adnexectomies by laparotomy, and 2 laparoscopic adnexectomies.     

胎儿畸形480例的超声诊断分析

目的：探讨超声检查发现胎儿先天发育异常的规律及诊断价值。方法：随机选择480例经产后及引产后证实的单胎妊娠的畸形胎儿,回顾性分析产前的超声检查资料,孕妇平均年龄27．6岁,平均孕周27．1周。超声诊断畸形儿统计标准：参照《中国出生缺陷监测报告卡》的监测类型和《临床技术操作规范（超声医学分册）》的检测畸形类型确定。结果：459例为经超声检出的胎儿先天畸形,21例为超声漏诊,根据胎儿出生后情况反馈为畸形。459例畸形胎儿,孕周在12-40周,其中24．4％（112／459）的病例是在18-24孕周之间检出,56．9％（261／459）的病例是在12—28孕周之间检出,其中24周检出病例数最多（42／459）。35．7％（164／459）的胎儿畸形是在孕28-36周期间检出。结论：超声对胎儿畸形的诊断符合率为95．62％（459／480）。妊娠28周前超声能检出大多数可检的胎儿畸形。超声在胎儿产前诊断上具有极高的诊断价值,诊断率高,无损伤性,操作简便,重复性强。     

Early pregnancy assessment with transvaginal ultrasound scanning.

OBJECTIVE: To establish normal parameters in early pregnancy through transvaginal ultrasonography so that gestational age can be determined and to correlate the sonographic findings with serum human chorionic gonadotropin (hCG) levels calibrated against the first international reference preparation standard. SETTING: Infertility clinic. PATIENTS: Thirty-five women with normal intrauterine pregnancy. INTERVENTIONS: Serial measurement of the serum hCG level and the diameter of the gestational sac through transvaginal ultrasonography. MAIN RESULTS: The gestational sac could not be visualized when the hCG level was less than 1100 IU/L. The average growth rate of the sac was 0.9 mm/d. The threshold values for sac diameter, serum hCG level and gestational age below which the yolk sac was not visible were 3.7 mm, 1900 IU/L and 36 days respectively; the corresponding values above which the yolk sac was always visible were 6.7 mm, 5800 IU/L and 40 days. The threshold values below which cardiac activity was not visible were 8.3 mm, 9200 IU/L and 41 days respectively, and the corresponding values above which cardiac activity was always visible were 14.0 mm, 24,000 IU/L and 46 days. The mean gestational ages and the 95% confidence and prediction intervals were tabulated so that measurement of the gestational sac diameter could be used to estimate gestational age early in normal pregnancy. CONCLUSIONS: Transvaginal ultrasonography enables detection of an intrauterine sac and reliable estimation of gestational age on the basis of sac dimensions before an embryo can be seen.