彩色多普勒超声结合β-HCG对妊娠滋养细胞疾病的诊断和疗效评价

摘要

ObjectiveTo study the diagnosis and theropeutic evaluation of color doppler ultrasound combined withβ-human chorionic gonadotropin(β-HCG)in the treatment of gestational trophoblastic disease.MethodsOne hundred and thirty-four patients with gestational trophoblastic disease which were all diagnosed by pathological examination and accepted color doppler ultrasonography were elected. The uterine size,blood flow and blood flow distribution richness under the ultrasound of all patients were retrospectively analyzed. The blood sinus size,resistance index (RI),the level of β-HCG and the uterine qutcomes quality before and after the treatment were observed.ResultsThese 59 cases diagnosed by ultrasound were benign lesions,and 16 cases of them were partial hydatidiform mole and chorionic degeneration patients,43 cases of them were hydatidiform mole patient. The ratio of correct diagnosis was 96.61%. These 75 cases diagnosed by ultrasound were malignant lesions,and 56 cases of them were invasive hydatidiform mole patients,17 cases of them were choriocarcinoma patients,2 cases of them were placental trophoblast cell tumor patients. The ratio of correct diagnosis was 100%. One hundred and eighteen patients accepted different period of follow-up,the follow-up rate was 88.06%. The blood sinus and uterine wall of blood flow of 51 patients with benign lesion and 67 patients with malignant lesion were restored to normal after uterine curettage surgery and chemotherapy. The RI was obviously higher than that before the treatment,the level of β-HCG was obviously lower than that before the treatment,there were significant differences(t=10.60,231.15,P<0.05).ConclusionThe ratio of correct diagnosis is high when doctors use color doppler ultrasound combined with β-HCG in the treatment of gestational trophoblastic disease which could accurately assess the condition degree and the prognosis of patient. It is a kind of efficient diagnosis and preoperative evaluation method.%目的：探讨彩色多普勒超声结合β-人绒毛膜促性腺激素（β-HCG）对妊娠滋养细胞疾病的诊断和疗效评价。方法选取妊娠滋养细胞疾病患者134例，均经病理学检查证实和接受彩色多普勒超声检查，回顾性分析所有患者超声表现下子宫大小、血流分布情况及血流丰富程度，同时观察血窦大小和血窦内阻力指数（RI），检测β-HCG水平，比较治疗前后子宫预后质量。结果经超声诊断为良性病变患者共59例，其中16例部分葡萄胎和胎盘部分变性患者和43例葡萄胎患者，诊断准确率为96.61％；经超声诊断为恶性病变患者共75例，其中56例侵蚀性葡萄胎患者、17例绒毛膜癌患者及2例胎盘滋养细胞肿瘤患者，诊断准确率为100％。118例患者接受不同时间段随访，随访率为88.06％。接受随访的51例良性病变患者和67例恶性病变患者经子宫刮宫术和化疗后血窦及子宫肌壁血流均恢复正常， RI明显高于治疗前，血清β-HCG水平明显低于治疗前，差异均有统计学意义（t分别=10.60、231.15，P均＜0.05）。结论应用彩色多普勒超声结合β-HCG对妊娠滋养细胞疾病的的临床准确率较高，可准确评估患者的病情程度及预后效果，是一种高效的诊断和评估疾病方法。