阴道彩超对宫角妊娠的诊断运用评价

目的：探究阴道彩超对宫角妊娠的诊断价值，为宫角妊娠的临床诊断提出有效方法。方法：对我院2010年4月～2013年4月收治的80例初诊宫角妊娠患者进行回顾性分析，对比其经腹彩超和经阴道彩超的的诊断结果与术后病理确诊差异。结果：阴道彩超下宫角妊娠共分三种表现，包括胚囊型、包块型和破裂型；阴道彩超显示，所有初诊宫角妊娠患者均可见孕囊与子宫内膜相连，其肌层厚度在7．5-11.3mm间，平均（10．5±1．7）mm；二次检查中，经腹超声确诊59例宫角妊娠，经阴道超声确诊51例，病理诊断共确诊宫角妊娠48例。经腹超声诊断准确率为81．4％，明显低于经阴道超声的94．1％，两组数据对比存在显著统计学差异。经腹超声两次检查符合率为73．8％，显著低于经阴道超声的96．2％，两组数据对比存在显著统计学差异。结论：阴道彩超较经腹彩超对宫角妊娠具有更高的诊断准确率，通过图像判断，能够有效对宫角妊娠、输卵菅间质部妊娠进行有效鉴别诊断，可作为指导临床早期干预方案、制定跟踪随访措施的关键依据。

Evaluation of Transvaginal Color Ultrasonic for the Diagnosis of Cornual Pregnancy

Objective： Explore the diagnostic value of transvaginal ultrasound for comual pregnancy so as to put forward effective means for the clinical diagnosis. Methods： A retrospective analysis was performed on 80 patients with cornual pregnancy who were ~treated in our hospital from April 2010 to April 2013. The diagnosis results and postoperative pathology were compared and analyzed between the abdominal ultrasonography and transvaginal ultrasound. Results： There were three kinds of manifestations of transvaginal color Doppler ultrasound cornual pregnancy, including the embryo sac type, mass type and fracture type; Transvaginal Color Doppler ultrasound showed that the embryo sac was connected to endometrium in all patients with comual pregnancy, the thickness of the muscle layer was 7.5~11.3 mm, the average was （10.5 ＋ 1.7） mm; in the second round detection, 59 cases of cornual pregnancy were diagnosed by the abdominal ultrasound, while 51 cases were diagnosed by the transvaginal ultrasound and 48 cases were diagnosed by the pathological. The accuracy rate of diagnosing by abdominal ultrasound was 81.4%, which was significantly lower than that of the transvaginal ultrasound 94.1%, and there was significant difference between the two groups. The qualified rate of transabdominal ultrasound twice was 73.8% which was significantly lower than that of the transvaginal ultrasound 96.2% and there was significant difference between the two groups. Conclusions： Compared with the transabdominal ultrasound for cornual pregnancy, the diagnosis accuracy of transvaginal ultrasound was higher. Transvaginal ultrasound can be formulated as a key follow-up measures to guide the clinical early intervention programs with the advantage of effective differential diagnosis to cornual pregnancy and interstitial tubal pregnancy.