摘要
目的:探讨阴道超声辅助腹腔镜手术治疗宫内外复合妊娠(HP)的疗效及对妊娠结局的影响。方法:选取在2021年1月至2022年6月期间,本院接收并治疗共计54名接受体外受精与胚胎移植技术(IVF-ET)后超声拟诊为HP的孕妇作为研究对象,按照随机数字表法分成对照组(术中无阴道超声辅助的腹腔镜手术)和观察组(行阴道超声辅助的腹腔镜手术),各27例。统计阴道超声声像图特征类型、超声诊断准确率,比较两组术中情况(中转开腹、异位妊娠包块破裂、输血)、术中出血量和手术时间、妊娠结局。结果:阴道超声图像特征包括胎囊型48例(88.89%),包块型2例(3.70%),漂浮型4例(7.41%),最终经阴道超声诊断为HP 50例,非HP 4例。手术证实HP患者54例,其中破裂型33例(61.11%),流产型18例(33.33%),未破裂型3例(5.56%)。阴道超声总诊断准确率为92.59%(50/54),漏诊率为7.41%(4/54)。两组术中中转开腹、异位妊娠包块破裂、输血情况差异无统计学意义(P>0.05)。观察组术中出血量[(61.45±17.37)mL]低于对照组[(86.23±18.72)mL],手术时间[(45.13±7.36)min]也短于对照组[(51.32±8.11)min](P<0.05)。两组妊娠结局活产率差异无统计学意义(P>0.05)。结论:阴道超声诊断HP的准确率为92.59%,且阴道超声辅助腹腔镜手术治疗HP能够有效减少手术过程中的出血量,并缩减手术时间,同时不会提升不良妊娠结局的风险,显示出良好的安全性。
Objective:To explore the efficacy of transvaginal ultrasound⁃assisted laparoscopic surgery in the treatment of intrauterine and extrauterine heterotopic pregnancy(HP)and its influence on pregnancy outcome.Methods:From January 2021 to June 2022,54 HP patients post⁃IVF⁃ET were randomized into control(laparoscopic surgery)and observation(laparoscopic with vaginal ultrasound)groups(27/group).Vaginal ultrasound’s characteristics and accuracy were analyzed,and intraoperative conditions,blood loss,time,and pregnancy outcomes were compared.Results:Characteristics of transvaginal ultrasound images showed 48 fetal cyst,2 mass,and 4 floating types,diagnosing 50/54 HP cases(92.59%accuracy,7.41%missed).Both groups had similar laparotomy conversions,ruptures,and transfusions(P>0.05).Observation group had less blood loss[(61.45±17.37)mL vs.(86.23±18.72)mL]and shorter ops[(45.13±7.36)min vs.(51.32±8.11)min](P<0.05).Live birth rates were comparable(P>0.05).Conclusion:The accuracy rate of diagnosing HP by transvaginal ultrasound is 92.59%,and the treatment of HP by transvaginal ultrasound⁃assisted laparoscopic surgery can effectively reduce the amount of bleeding during the operation and shorten the operation time,without increasing the risk of adverse pregnancy outcome,showing good safety.
作者
吕双军
尚琴琴
朱丽
毛剑
刘何利
LYU Shuangjun;SHANG Qinqin;ZHU Li;MAO Jian;LIU Heli(Physical Examination Department,Cangzhou Hospital of Integrated TCM-WM·Hebei,Hebei 061000,China;Department of Reproductive Medicine,Cangzhou Hospital of Integrated TCM-WM·Hebei,Hebei 061000,China;Ultrasound Depart-ment 1,Cangzhou Hospital of Integrated TCM-WM·Hebei,Hebei 061000,China;Ultrasound Department,Cangzhou Hos-pital of Integrated TCM-WM·Hebei,Hebei 061000,China;Ultrasound Department 2,Cangzhou Hospital of Integrated TCM-WM·Hebei,Hebei 061000,China)
出处
《影像科学与光化学》
2025年第4期40-45,52,共7页
Imaging Science and Photochemistry
基金
2022年度河北省医学研究课题(20220682)。
关键词
宫内外复合妊娠
阴道超声
腹腔镜
准确率
妊娠结局
术中出血量
intrauterine and extrauterine heterotopic pregnancy
transvaginal ultrasonography
laparoscopy
accuracy
pregnancy outcome
intraoperative bleeding volume
