Abstract
Objective:To investigate the diagnostic effect and differential value of abdominal ultrasonography combined with vaginal ultrasonography in patients with gynecological acute abdomen.Methods:Data of 120 patients with highly suspected gynecological acute abdomen in the Dujiangyan Second People's Hospital from January 2022 to January 2024 were retrospectively analysed.All patients underwent abdominal ultrasonography,vaginal ultrasonography and combined examination(abdominal ultrasonography combined with vaginal ultrasonography).The results of pathological examination were used as the gold standard to analyze the clinical diagnosis effect of 3 different examination methods.Results:A total of 88 cases of 120 patients with highly suspected gynecological acute abdomen were positive,including 30 cases of ectopic pregnancy,16 cases of acute pelvic inflammation,22 cases of torsion of ovarian cyst and 20 cases of corpus luteum rupture;32 cases were negative,including 22 acute abdominal pain and 10 acute appendicitis.The results of abdominal ultrasonography showed 70 positive cases and 50 negative cases,the sensitivity,specificity,accuracy,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value were 68.18%,68.75%,68.33%,31.25%,31.82%,85.71%and 44.00%,respectively.The results of vaginal ultrasonography showed 76 positive cases and 44 negative cases,the sensitivity,specificity,accuracy,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value were 78.41%,78.13%,78.33%,21.88%,21.59%,90.79%and 56.82%,respectively.The results of joint examination showed that 87 cases were positive and 33 cases were negative,the sensitivity,specificity,accuracy,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value were 97.73%,96.88%,97.50%,3.13%,2.27%,98.85%and 93.94%,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of combined examination were higher than those of single abdominal ultrasound and single vaginal ultrasound,and the misdiagnosis rate and missed diagnosis rate of combined examination were lower than that of single abdominal ultrasound and single vaginal ultrasound,with statistical significance(P<0.05).In the differential diagnosis of patients with positive combined examination,30 cases of ectopic pregnancy,16 cases of acute pelvic inflammatory disease,22 cases of torsion of ovarian cyst and 20 cases of luteal rupture were detected,the accuracy was 100.00%(30/30),93.75%(15/16),100.00%(22/22),100.00%(20/20),respectively.Conclusion:Abdominal ultrasonography combined with vaginal ultrasonography is more valuable than single abdominal ultrasonography and single vaginal ultrasonography in diagnosing and differentiating patients with gynecological acute abdomen,and has important clinical significance.关键词
妇科急腹症/腹部超声/阴道超声/诊断效果/鉴别价值Key words
Gynecological acute abdomen/Abdominal ultrasound/Vaginal ultrasound/Diagnostic effect/Differential value分类
医药卫生
