The Value In Patients With Ectopic Pregnancy Using Combined Detection And Diagnosis Of Three Indexes Indicators,HCG,Progesterone And Endometrial Thickness

Objective: Ectopic pregnancy(EP),an abnormal pregnancy develops outside the uterus,also known as pregnancy outside the uterus.Ectopic pregnancy is a common acute abdominal disease of obstetrics and gynecology,after fracture occurs when the ectopic pregnancy or abortion,can cause acute abdominal cavity hemorrhage,serious endanger the patient lives,and pregnancy-related disease mortality is high.In clinical practice,most patients with ectopic pregnancy can be diagnosed before serious internal hemorrhage,and be treated promptly before severe internal hemorrhage.But there are many individuals,especially the clinical signs and symptoms are not typical,often lead to misdiagnosis easily,so early detection of cases of ectopic pregnancy,timely termination of pregnancy is an effective way to reduce the maternal hemorrhage and mortality.Combined with the publicatons in China and abroad in recent years have reported that the incidence of ectopic pregnancy is obviously rising,and is more in younger pregnancy ones.So to explore the diagnostic methods of early and rapid diagnosis of ectopic pregnancy is imminent.This study is to explore the joint using human chorionic gonadotropin(?-HCG).Methods:1 Samples: to choose Zhengding county people's hospital in January 2016 to January 2017 in treating obstetrics and gynecology hospital during the period of 70 patients with ectopic pregnancy as ectopic pregnancy group,and ultimately,these patients by surgery and pathology screening clear diagnosis of ectopic pregnancy;In the same period,70 cases of normal early pregnancy were selected as normal early pregnancy group(control group).Detection and compared two groups of patients: human chorionic gonadotropin(?-HCG),progesterone and B ultrasonic detecting endometrial thickness,after study the indicators alone detection and joint detection for early diagnosis of ectopic pregnancy,sensitivity,specificity,misdiagnosis rate,missed diagnosis,diagnostic coincidence rate.2 Test methods: all patients were examined by the philips color ultrasonography after filling the bladder to determine the thickness of the uterus.The beckman coulter chemical illuminator tests serum ?-HCG and progesterone levels.The data of endometrial thickness,serum ?-HCG and progesterone were analyzed.3 Statistical methods: the data were processed by SPSS 22 statistical software.Measurement data with normal distribution data to ?x + s indicate that the data of the two groups were compared using t test and non normal distribution data after logarithm transformation,Kruskal Wallis nonparametric.Count data using the percentage of cases or statistics.The chi square test,were analyzed.P < 0.05 indicates that the difference was statistically significant.Results:1 Etopic pregnancy group and normal early pregnancy group general data comparison.two groups among basic data,age,height,weight,menstrual cycle,menopause days and other basic data,the difference was not statistically significant(P > 0.05)2 Diagnostic indicators examination.Ectopic pregnancy patients' ?-HCG,Prog and endometrial thickness respectively(4877.4 ± 1072.1miu/ml),(3.47 ±0.71 ng/ml),(5.97 ± 0.95mm),decreased compared with those in normal pregnancy group(11141.5 ± 2162.2miu/ml),(38.69 ± 9.02ng/ml),(15.87 ±1.6mm)(P < 0.05).3 Single index evaluation.Diagnostic sensitivity of 80% serum ?-HCG,the specificity was 56.3%,misdiagnosis rate was 20%,the misdiagnosis rate was 43.7%,the coincidence rate was 75.6%;the progesterone sensitivity was77.1%,the specificity was 81.3%,the missed diagnosis rate was 22.9%,the misdiagnosis rate was 18.7%,the coincidence rate was 77.9%;the sensitivity of ultrasound endometrial thickness was 82.9%,the specificity was 87.5%,themissed diagnosis rate was 17.1%,the misdiagnosis rate was 12.5%,the diagnostic rate was 83.7%.4 Combined indexes diagnostic evaluation.The sensitivity of the combined three indexes was 87.1%,and the specificity of the indexes was92.8%.The diagnostic coincidence rate was improved into 88.4%.The rate of misdiagnosis was 12.9%,and the misdiagnosis rate was 6.2%,both of which decreased greatly.Conclusions: The detection sensitivity of single index in ultrasound endometrial thickness,the rate of missed diagnosis,and the diagnostic coincidence rate superiors to that of single detection of ?-HCG and progesterone.Single detection of progesterone on the specificity and misdiagnosis rate superiors to that of the single detection of ?-HCG and?-HCG alone.Detection of misdiagnosis rate superiors to that of single detection and diagnosis.The three joint diagnostic sensitivity,specificity,diagnostic and coincidence rate is greatly improved and decreased the rate of misdiagnosis and missed diagnosis rate.Combined indexes diagnostic evaluation provides better clinical detection of ectopic pregnancy rapid noninvasive diagnostic methods.