Tang Shuai, Zhou Qing, Zhang Yuelun, Chen Lin, Yu Xuerong, Zhang Yanming, Qi Zhenhong, Xia Yu, Huang Yuguang
Department of Anesthesiology, Peking Union Medical College Hospital, CAMS & PUMC, Beijing, China.
Department of Ultrasound, Peking Union Medical College Hospital, CAMS & PUMC, Beijing, China.
Emerg Med Int. 2020 Dec 10;2020:8874581. doi: 10.1155/2020/8874581. eCollection 2020.
The ultrasonic finding of pelvic free fluid which suggests the possibility of internal haemorrhage helps the determination of the severity of patients.
We conducted a retrospective study investigating ultrasonic measurements and haemorrhage volumes in patients having an ectopic pregnancy in a single centre from January 2013 to November 2016. The logistic regression model was used to establish the prediction model for haemorrhage volumes. The diagnostic accuracy was evaluated by area under ROC curve (AUC) analysis. We employed 800 ml as the cut-off point of the haemorrhage and further set it to 1000 ml and 1200 ml in the sensitivity analysis.
The mean pelvic free fluid depths measured by TVS and TAS were 4.45 ± 2.15 cm and 4.45 ± 2.56 cm in the haemorrhage ≥800 ml group, while they were 2.48 ± 1.51 cm and 2.55 ± 1.19 cm in <800 ml group. AUCs and the corresponding cut-off points were 0.741 (95% CI 0.677 to 0.804) and 0.118 when predicted by the standardised depths of TVS and TAS, 0.784 (95% CI 0.696-0.872) and 2.95 cm by the raw depths of TVS, and 0.748 (95% CI 0.665-0.831) and 3.35 cm by the raw depths of TAS.
The depth of pelvic free fluid measured by TVS and TAS can be used to predict blood loss volume in patients having an ectopic pregnancy. TVS may perform better than TAS.
超声检查发现盆腔游离液体提示存在内出血的可能性,有助于判断患者的病情严重程度。
我们进行了一项回顾性研究,调查了2013年1月至2016年11月在单一中心患有异位妊娠患者的超声测量值和出血量。采用逻辑回归模型建立出血量预测模型。通过ROC曲线下面积(AUC)分析评估诊断准确性。我们将800ml作为出血量的截断点,并在敏感性分析中将其进一步设定为1000ml和1200ml。
在出血量≥800ml组中,经阴道超声(TVS)和经腹超声(TAS)测量的平均盆腔游离液体深度分别为4.45±2.15cm和4.45±2.56cm,而在<800ml组中分别为2.48±1.51cm和2.55±1.19cm。当通过TVS和TAS的标准化深度进行预测时,AUC值及相应截断点分别为0.741(95%CI 0.677至0.804)和0.118;通过TVS原始深度预测时为0.784(95%CI 0.696 - 0.872)和2.95cm;通过TAS原始深度预测时为0.748(95%CI 0.665 - 0.831)和3.35cm。
TVS和TAS测量的盆腔游离液体深度可用于预测异位妊娠患者的失血量。TVS可能比TAS表现更好。