本文選題：超聲 + 宮頸長(zhǎng)度�。� 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的探討超聲測(cè)宮頸長(zhǎng)度預(yù)測(cè)早產(chǎn)的臨床意義,并對(duì)經(jīng)腹、經(jīng)陰道與經(jīng)會(huì)陰三種超聲途徑測(cè)宮頸長(zhǎng)度預(yù)測(cè)早產(chǎn)進(jìn)行比較。對(duì)象及方法對(duì)2012年1月至2014年1月有先兆早產(chǎn)征象來我院就診的孕婦行超聲測(cè)宮頸長(zhǎng)度預(yù)測(cè)早產(chǎn),經(jīng)腹掃查278例(經(jīng)腹組)、經(jīng)陰道掃查297例(經(jīng)陰道組)、經(jīng)會(huì)陰掃查301例(經(jīng)會(huì)陰組),記錄宮頸長(zhǎng)度(CL)并追蹤妊娠結(jié)局,并對(duì)三種方法進(jìn)行比較。結(jié)果①孕婦接受率經(jīng)腹組為100%,經(jīng)陰道組為81.1%,經(jīng)會(huì)陰組為99.3%,經(jīng)陰道組孕婦接受率明顯低于經(jīng)腹組和經(jīng)會(huì)陰組,P0.01,有極顯著統(tǒng)計(jì)學(xué)差異。②宮頸實(shí)現(xiàn)率經(jīng)腹組為84.2%,經(jīng)陰道組為98.8%,經(jīng)會(huì)陰組為98.3%,經(jīng)腹組宮頸實(shí)現(xiàn)率明顯低于經(jīng)陰道組和經(jīng)會(huì)陰組,P0.01,有非常顯著統(tǒng)計(jì)學(xué)差異。③順利完成檢查共766例,其中共164例早產(chǎn),602例足月產(chǎn),按CL2.0cm、2.0cm≤CL2.5cm、2.5≤CL3.0cm、3.0≤CL3.4cm, CL≥3.5cm分組分別預(yù)測(cè)早產(chǎn)的敏感性、特異性、陽性預(yù)測(cè)值及陰性預(yù)測(cè)值,發(fā)現(xiàn)CL3.0cm時(shí)發(fā)生早產(chǎn)的敏感性和特異性之和為最大值。④經(jīng)腹組CL3.Ocm孕婦早產(chǎn)率為54.3%,經(jīng)陰道組為55.1%,經(jīng)會(huì)陰組為56.3%, CL≥3.0cm孕婦早產(chǎn)率經(jīng)腹組為9%,經(jīng)陰道組為8.1%,經(jīng)會(huì)陰組為8.6%,三組CL3.0cm和CL≥3.0cm孕婦早產(chǎn)率比較均有明顯差異,有統(tǒng)計(jì)學(xué)意義。⑤CL3.0cm預(yù)測(cè)早產(chǎn)敏感性經(jīng)腹組為51.4%,經(jīng)陰道組為76.8%,經(jīng)會(huì)陰組為76.1%,經(jīng)腹組明顯低于經(jīng)陰道組和經(jīng)會(huì)陰組,P0.01,有非常顯著統(tǒng)計(jì)學(xué)差異。結(jié)論①超聲測(cè)宮頸長(zhǎng)度預(yù)測(cè)早產(chǎn)是有較大臨床意義的,無論是經(jīng)腹,經(jīng)陰道還是經(jīng)會(huì)陰測(cè)量。②宮頸長(zhǎng)度3.0cm時(shí),敏感性和特異性之和最大,即將3.0cm作為測(cè)量宮頸長(zhǎng)度預(yù)測(cè)早產(chǎn)的臨界值,以宮頸長(zhǎng)度3.0cm診斷為宮頸異常,預(yù)測(cè)早產(chǎn)準(zhǔn)確性最高,最具有臨床意義,可作為預(yù)防早產(chǎn)的界值。③綜合比較經(jīng)會(huì)陰途徑測(cè)宮頸長(zhǎng)度更具優(yōu)勢(shì),值得推廣。圖6幅,表5個(gè),參考文獻(xiàn)31篇。
[Abstract]:Objective to explore the clinical significance of cervical length measurement by ultrasonography in preterm labor and to compare the cervical length prediction by transabdominal transvaginal and perineal ultrasound. Participants and methods pregnant women who had signs of premature labor from January 2012 to January 2014 were measured by ultrasound to predict the length of cervix. 278 cases were examined by abdominal scan (transabdominal group, 297 cases by vagina scan (transvaginal group), 301 cases by perineum scan (transperineal group, cervical length CLL), and pregnancy outcome was tracked, and the three methods were compared. Results 1 the acceptance rate of pregnant women was 100 in the abdominal group, 81.1 in the vaginal group and 99.3 in the perineum group. The acceptance rate of pregnant women in the vaginal group was significantly lower than that in the abdominal group and the perineum group (P 0.01). The cervical realization rate in the transabdominal group was significantly lower than that in the vaginal group and the transperineal group (P 0.01). There was a very significant difference between the two groups (766 cases). A total of 602 cases of preterm labor were diagnosed. According to CL2.0 cm ~ (2. 0) cm 鈮，

本文編號(hào)：1990861