摘要
目的分析凶险性前置胎盘(DPP)诊断中经腹部超声(TAS)联合血人绒毛膜促性腺激素(HCG)的准确率、灵敏度、特异度。方法选定我院超声医学科2019年10月至2021年10月接诊的50例高度疑似DPP患者,分别给予TAS、HCG检查,对比TAS、HCG、TAS+HCG诊断DPP以及胎盘植入(PA)的准确率、灵敏度、特异度,将产后病理诊断结果作为本次研究金标准,单独、联合诊断与金标准的一致性行Kappa检验,比较DPP组、DPP合并PA组胎盘厚度、血清HCG。结果TAS+HCG诊断DPP准确率(92.0%)、灵敏度(92.7%)、特异度(88.9%)均高于TAS(40.0%、46.3%、11.8%)、HCG(48.0%、53.7%、22.2%),Kappa检验TAS+HCG与产后病理诊断的一致性较好(Kappa值=0.796),TAS、HCG与产后病理诊断的一致性一般(Kappa值=0.607、0.599)。TAS+HCG诊断DPP合并PA准确率(75.6%)、灵敏度(71.0%)均高于TAS(31.7%、19.4%)、HCG(29.3%、12.9%),TAS+HCG诊断DPP合并PA特异度(90.0%)与TAS(70.0%)、HCG(80.0%)比较差异无统计学意义(P>0.05),Kappa检验TAS+HCG与产后病理诊断的一致性较好(Kappa值=0.757),TAS、HCG与产后病理诊断的一致性一般(Kappa值=0.575、0.566,P<0.05)。DPP合并PA组胎盘厚度、血清HCG均高于DPP组(P<0.05)。结论TAS联合HCG可提高DPP诊断准确率、灵敏度、特异度,并鉴别是否存在PA,具有较高的临床诊断、应用价值。
Objective To analyze the accuracy,sensitivity and specificity of transabdominal ultrasound(TAS)combined with blood human chorionic gonadotropin(HCG)in the diagnosis of dangerous placenta previa(DPP).Methods Fifty patients with high suspicion of DPP who were admitted to the Department of Ultrasound Medicine in our hospital from October 2019 to October 2021 were selected and given TAS and HCG examinations,respectively,and compared TAS,HCG,TAS+HCG to diagnose DPP and placenta accreta The accuracy,sensitivity,and specificity of PA,the postpartum pathological diagnosis results were used as the gold standard in this study,the consistency of Kappa test alone and combined diagnosis and the gold standard was compared,and placental thickness and serum HCG were compared in the DPP group and DPP combined PA group.Results The accuracy rate(92.0%),sensitivity(92.7%)and specificity(88.9%)of TAS+HCG in diagnosing DPP were higher than those of TAS(40.0%,46.3%,11.8%),HCG(48.0%,53.7%,22.2%),the Kappa test TAS+HCG had good consistency with postpartum pathological diagnosis(Kappa=0.796),and the consistency between TAS,HCG and postpartum pathological diagnosis was general(Kappa=0.607,0.599).The accuracy(75.6%)and sensitivity(71.0%)of TAS+HCG in the diagnosis of DPP combined with PA were higher than those of TAS(31.7%,19.4%)and HCG(29.3%,12.9%),P<0.05,TAS+HCG in the diagnosis of DPP combined The specificity of PA(90.0%)was compared with that of TAS(70.0%)and HCG(80.0%).The Kappa test was in good agreement between TAS+HCG and postpartum pathological diagnosis(Kappa=0.757).The consistency of postpartum pathological diagnosis was general(Kappa value=0.575,0.566),P<0.05.The placenta thickness and serum HCG in DPP combined with PA group were higher than those in DPP group(P<0.05).Conclusion TAS combined with HCG can improve the diagnostic accuracy,sensitivity and specificity of DPP,and identify the presence or absence of PA,which has high clinical diagnosis and application value.
作者
荣洁
Rong Jie(Department of Ultrasound,Nanyang Central Hospital,Henan473000,China)
出处
《实用医学影像杂志》
2023年第3期206-210,共5页
Journal of Practical Medical Imaging
关键词
前置胎盘
经腹部超声检查
人绒毛膜促性腺激素
诊断效能
Placenta previa
Transabdominal ultrasnography
Human chorionic gonadotropin
Diagnostic efficacy
