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目的:探讨输卵管妊娠的早期诊断方法。方法:停经45 d内的可疑早期异位妊娠患者83例,行阴道后穹隆穿刺取得腹腔液,同时进行腹腔液及静脉血清β-hCG、E2、P定量测定,以腹腔液β-hCG/血清β-hCG的比值分组,临床追踪妊娠预后,以腹腔镜手术病理诊断或诊刮病理诊断作为明确宫内、外妊娠的依据,并将腹腔液β-hCG/血清β-hCG的比值与妊娠结局进行关联分析。结果:腹腔液β-hCG/血β-hCG比值>1者均为输卵管妊娠;腹腔液β-hCG/血β-hCG比值<1者均为宫内妊娠,输卵管妊娠患者腹腔液及血清E2、P值明显低于宫内妊娠者,E2、P的腹腔液与外周血比值在两组间无统计学差异。行后穹隆穿刺无一例发生感染。结论:腹腔液β-hCG/血β-hCG的比值是早期输卵管妊娠的准确诊断依据,凡腹腔液β-hCG明显高于静脉血β-hCG者为输卵管妊娠,反之为宫内妊娠,符合率为100%。
Objective: To explore the early diagnosis of tubal pregnancy. Methods: 83 cases of suspected early ectopic pregnancy were enrolled in 45 days after menopause. Peritoneal fluid was obtained by vaginal and posterior fornix puncturation. Β-hCG, E2 and P levels in peritoneal fluid and venous serum were measured simultaneously. Peritoneal fluid β-hCG / serum β-hCG ratio group, the clinical follow-up of pregnancy prognosis, pathological diagnosis of laparoscopic surgery or diagnosis of curettage as a clear basis for intrauterine and extra-pregnancy, and peritoneal fluid β-hCG / serum β-hCG ratio and pregnancy outcome Perform correlation analysis. Results: The peritoneal fluid β-hCG / blood β-hCG ratio> 1 were tubal pregnancy; peritoneal fluid β-hCG / blood β-hCG ratio <1 were intrauterine pregnancy, tubal pregnancy in patients with peritoneal fluid and serum E2, P value was significantly lower than intrauterine pregnancy, E2, P peritoneal fluid and peripheral blood ratio was no significant difference between the two groups. No case of infection after the line of dome puncture. Conclusion: The ratio of β-hCG / β-hCG in peritoneal fluid is the basis of accurate diagnosis of early tubal pregnancy. Whereas β-hCG in peritoneal fluid is significantly higher than that of β-hCG in blood, it is intrauterine pregnancy, It is 100%.