【摘要】：目的：從循證醫(yī)學角度將生化學指標（血清β-HCG）與影像學指標（彩色多普勒超聲測量子宮內(nèi)膜厚度）結合起來，評價其在異位妊娠中的診斷價值。 方法：對吉林大學第一附屬醫(yī)院于2010年1月1日至2012年7月1日期間到婦科就診的、孕周為5-7周、疑似異位妊娠的358例患者的臨床資料進行分析，并應用SASS9.0軟件進行統(tǒng)計學分析。 結果：本組資料中，患者年齡17-45歲,平均29.47±6.68歲，，平均孕周5.57±0.55周，經(jīng)手術、病理、彩色多普勒超聲檢查和血清β-HCG檢測的方法確診正常妊娠患者80例，自然流產(chǎn)患者82例，異位妊娠患者196例。妊娠的周數(shù)比較，即正常妊娠組（6.02±0.36），妊娠流產(chǎn)組(5.81±0.34)與異位妊娠組（5.27±0.49），三者比較無統(tǒng)計學意義（p0.05）。在相同條件下（妊娠5-7周），正常妊娠組血清β-HCG值（1252.07±189.0IU/L）明顯高于妊娠流產(chǎn)組（900.50±192.22IU/L）及異位妊娠組（824.63±229.02IU/L），該差異有統(tǒng)計學意義（p㩳0.05），而流產(chǎn)妊娠組與異位妊娠組相比差異無統(tǒng)計學意義（p㧐0.05）。彩色多普勒超聲下診斷子宮內(nèi)膜厚度顯示，正常妊娠組（11.33±0.77mm）大于妊娠流產(chǎn)組（7.93±1.22mm）及異位妊娠組（6.69±1.49mm）（p㩳0.05），但后兩者相比差異無統(tǒng)計學意義（p㧐0.05）。單獨檢測血清人絨毛膜促性腺激素結果檢出率為45.9%，單獨檢查彩色多普勒超聲下子宮內(nèi)膜厚度結果符合率為51.0%，二者聯(lián)合檢測診斷符合率為98%（p㩳0.05），各種檢查在診斷異位中的特異性和敏感性忽略不計。 結論：眾多輔助方法之中，以影像學指標作為首選，因其可以直觀檢測；如結合血清人絨毛膜促性腺激素（血清β-HCG值）能更有效診斷異位妊娠。
[Abstract]:Objective: to evaluate the diagnostic value of biochemical index (serum 尾 -HCG) and imaging index (color Doppler ultrasound for endometrial thickness) in ectopic pregnancy from the perspective of evidence-based medicine. Methods: the clinical data of 358 patients with suspected ectopic pregnancy from January 1, 2010 to July 1, 2012 in the first affiliated Hospital of Jilin University were analyzed. SASS9.0 software was used for statistical analysis. Results: the age of the patients was 17-45 years old (mean 29.47 鹵6.68 years, mean gestational age 5.57 鹵0.55 weeks). 80 cases of normal pregnancy and 82 cases of spontaneous abortion were confirmed by operation, pathology, color Doppler ultrasound and serum 尾 -HCG. 196 cases of ectopic pregnancy. The number of weeks of pregnancy was (6.02 鹵0.36) in normal pregnancy group, (5.81 鹵0.34) in abortion group and (5.27 鹵0.49) in ectopic pregnancy group. There was no significant difference among the three groups (p0.05). Under the same condition (5-7 weeks of pregnancy), the serum 尾 -HCG level in normal pregnancy group (1252.07 鹵189.0IU/L) was significantly higher than that in abortion group (900.50 鹵192.22IU/L) and ectopic pregnancy group (824.63 鹵229.02IU/L), but there was no significant difference between abortion group and ectopic pregnancy group (p0.05). The thickness of endometrium in normal pregnancy group (11.33 鹵0.77mm) was higher than that in normal pregnancy group (7.93 鹵1.22mm) and ectopic pregnancy group (6.69 鹵1.49mm), but there was no significant difference between the latter two groups. The detection rate of serum human chorionic gonadotropin alone was 45.9. The coincidence rate of endometrial thickness under color Doppler ultrasound was 51.0. The diagnostic coincidence rate of the two combined detection was 98% (p0.05). The specificity and sensitivity were ignored. Conclusion: among the many auxiliary methods, imaging index is the first choice because it can be detected directly, such as serum human chorionic gonadotropin (serum 尾 -HCG) can be used to diagnose ectopic pregnancy more effectively.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.22;R445.1

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