Lipscomb G H, Gildner K, Shulman L P, Eltorky M, McCord M L, Ling F W
Department of Obstetrics and Gynecology, University of Tennessee, Memphis, USA.
Int J Gynaecol Obstet. 1998 Nov;63(2):153-8. doi: 10.1016/s0020-7292(98)00143-x.
To compare Karman cannula aspiration followed by dissecting microscopy with suction curettage and permanent histology in obtaining and identifying chorionic villi.
Karman cannula aspiration was performed before standard curettage for failed intrauterine pregnancies (N=22) or possible ectopic gestation (N=24). Dissection microscopy for chorionic villi was performed on aspirates before submission for permanent histology. Sensitivity, specificity, positive and negative predictive value of each method in obtaining and identifying villi was determined.
Overall, all methods were only moderately sensitive in detecting chorionic villi (50-76%). If failed intrauterine pregnancies were excluded, all methods had poor sensitivity (25-64%). However, if villi were detected, the positive predictive value of all methods was high (> 80%).
Karman cannula aspiration followed by dissecting microscope examination or permanent histology may offer an alternative to traditional curettage in the diagnosis of ectopic gestations. A larger trial to validate these findings seems justified.
比较采用卡曼套管抽吸术并结合解剖显微镜检查与刮宫术及永久组织学检查在获取和识别绒毛方面的差异。
对于宫内妊娠失败（N = 22）或可能为异位妊娠（N = 24）的患者，在进行标准刮宫术前先采用卡曼套管抽吸术。在将抽吸物送检进行永久组织学检查之前，先通过解剖显微镜对绒毛进行检查。确定了每种方法在获取和识别绒毛方面的敏感性、特异性、阳性预测值和阴性预测值。
总体而言，所有方法在检测绒毛方面的敏感性仅为中等水平（50 - 76%）。如果排除宫内妊娠失败的情况，所有方法的敏感性都较差（25 - 64%）。然而，如果检测到绒毛，所有方法的阳性预测值都很高（> 80%）。
采用卡曼套管抽吸术并结合解剖显微镜检查或永久组织学检查，在异位妊娠的诊断中可能是传统刮宫术的一种替代方法。进行一项更大规模的试验以验证这些发现似乎是合理的。
