浙江医学2023，Vol.45Issue(23)：2502-2508,7.DOI:10.12056/j.issn.1006-2785.2023.45.23.2023-699
经阴道三维能量多普勒血管成像在异位妊娠药物治疗中的应用价值
Transvaginal three dimension-power Doppler angiography in conservative treatment of ectopic pregnancy
摘要
Abstract
Objective To evaluate the application of transverginal three dimension-power Doppler angiography(3D-PDA)in evaluating the treatment efficacy and predicting the treatment outcome in patients with ectopic pregnancy(EP).Methods A total of 77 EP patients who received drug treatment in Wenzhou People's Hospital from January 2019 to June 2022 were enrolled,among whom,the treatment was successful after a single injection of methotrexate(MTX)in 45 cases(single injection success group),the treatment was successful after the second injection of MTX in 19 cases(second injection success group),and the treatment failed after the second injection of MTX in 13 cases(failure group).The age,duration of menopause,ultrasound data of EP masses and human chorionic gonadotropin(hCG)levels of patients were collected.The ultrasound parameters of EP mass,including volume(V),vascularization index(VI),flow index(Fl),vascularization flow index(VFI),and hCG levels were measured before treatment d4,d7 after treatment.The correlation of ultrasound parameters and hCG levels with treatment outcome was analyzed.The values of V,VI,FI,VFI and hCG levels in predicting treatment outcome were assessed with ROC curve.Results There were significant differences in ultrasound parameters V,VI,FI and VFI before treatment among the three groups(all P＜0.01);and the area under ROC curves(AUC)of above parameters in predicting treatment outcome were all higher than 0.800.Parameter Fl and the change rates of VI0-4,FI0-4 and VFI0-4 at d4 after treatment had high predicting efficacy for the failure of single injection,while V,VI,Fl,VFI and the change rates of VI0-4,FI0-4 and VFI0-4 had good predicting efficacy for the failure of two injections of MTX.The ultrasound parameters and their change rates,as well as hCG levels on d7 after treatment had better predicting efficacy for the outcome in patients receiving two injections of MTX.Conclusion 3D-PDA combined with VOCAL software and dynamic measurement of hCG level can effectively predict the treatment outcome in patients with ectopic pregnancy receiving conservative drug treatment.关键词
异位妊娠/预后/三维超声/甲氨蝶呤/保守治疗Key words
Ectopic pregnancy/Prognosis/Three-dimensional ultrasound/Methotrexate/Conservative treatment引用本文复制引用
陈丹,尤利益,焦岩,邹震宇..经阴道三维能量多普勒血管成像在异位妊娠药物治疗中的应用价值[J].浙江医学,2023,45(23):2502-2508,7.基金项目
温州市基础性医疗卫生科技项目(Y2020823) （Y2020823）
