冼晓菊　尹海辉

[關键词] 腹部超声;阴道超声;临床诊断;妇科急腹症

[中图分类号] R656.1;R730.41          [文献标识码] B          [文章编号] 1673-9701（2021）17-0103-04

Application value of ultrasonic diagnosis in clinical diagnosis of patients with gynecological acute abdomen

XIAN Xiaoju   YIN Haihui

Department of Ultrasonography Medicine，the Second Hospital Affiliated to University of South China，Hengyang 421001，China

[Abstract] Objective To investigate the application value of ultrasonic diagnosis in clinical diagnosis of patients with gynecological acute abdomen. Methods A total of 114 patients with gynecological acute abdomen treated in our hospital from January 2019 to September 2020 were randomly selected as the study objects. All patients were examined by abdominal ultrasonography and vaginal ultrasonography，respectively. The diagnostic accuracies of different ultrasonic diagnostic methods for gynecological acute abdomen were compared， and the corresponding ultrasonic features of each gynecological acute abdomen were analyzed in detail. Results According to the results of abdominal and vaginal ultrasonic diagnosis， except for corpus luteum rupture， ovarian cyst rupture and hemorrhagic salpingitis， the diagnostic accuracies of other types of gynecological acute abdomen and the overall confirmation rate of gynecological acute abdomen by vaginal ultrasonography were all higher than those by abdominal ultrasonography （P<0.05）. After analyzing the ultrasonic features of different gynecological acute abdomens，it was found that the endometrium of ectopic pregnancy patients was obviously thickened. In addition，there was no gestational sac ultrasound in the uterine cavity，and there were heterogeneous masses in the adnexal area，which were irregular in shape，accompanied by internal chaotic echoes and blurred boundaries. There were heterogeneous masses in the adnexal part of patients with corpus luteum rupture，the boundary part was blurred，and some patients had ascites. There were heterogeneous echo and cystic mass in the uterine adnexa region of patients with ovarian cyst rupture， and there was free effusion in the abdominal cavity and pelvic cavity. In patients with acute pelvic inflammatory disease，the oviduct was thickened，the internal echo was complicated， and the sound transmission in the dark area was poor. In addition， there were oval cystic masses at the site of oviduct cyst， with thick cyst wall and dotted or flocculent echo feedback inside. Conclusion Compared with abdominal ultrasonic diagnosis， the application value of vaginal ultrasonic diagnosis in the clinical diagnosis of patients with gynecological acute abdomen is more remarkable. It can effectively improve the accuracy of disease diagnosis and accurately distinguish specific disease types. Therefore，it is worthy of promotion and application.

[Key words]Abdominal ultrasonography; Vaginal ultrasonography; Clinical diagnosis; Gynecological acute abdomen

婦科急腹症是一种以急性腹痛为典型症状的妇产科疾病类型，患者在病情发展影响下可逐渐出现不同程度的反跳痛、肌肉紧张、高热等症状表现，若未能得到及时有效的对症治疗干预，则可导致患者发生休克等情况，进而可对患者的生命安全及健康水平均带来严重的不良影响[1]。因此，尽早给予患者准确有效的临床诊断及对症治疗干预是十分重要的。近年来，随着影像学诊疗技术水平的不断提升，超声诊断现已在临床范围内得到了有效应用，该检查方法可通过对病变部位的组织形态、大小、血流情况等方面展开有效探查，进而充分明确机体病变表现发展情况，从而可为患者的临床诊断提供重要的参考依据[2]。为进一步探讨上述诊断方法的临床应用价值，本研究主要分析了超声诊断在妇科急腹症患者临床诊断中的应用效果，现报道如下。

1 资料与方法

1.1一般资料

于2019年1月至2020年9月期间本院就诊的妇科急腹症患者中随机抽取114例作为研究对象，患者年龄21～49岁，平均（35.17±4.36）岁;患者入院后均主诉存在不同程度的腹痛表现，且伴有停经、发热、白带异常等机体症状，腹痛持续时间为11～45 min，平均（23.45±3.16）min。

纳入标准：①经临床综合诊断确诊为妇科急腹症者[3];②均已签署研究知情同意书者;③可主动配合开展研究内容者。

排除标准：①合并患有严重的脏器功能疾病者;②合并存在精神障碍相关症状表现者[4];③参与研究前已接受病情相关对症治疗干预者;④临床资料不完整者。……