经阴道超声观察早早孕子宫内膜特征在临床药物流产中的应用  

The clinical use of ultrasonic uterine membrane character of very early pregnancy via vagina in medicinal abortion

作　　者：刘欣友[1] 胡萌[1] 邹凤云[1] 张琳[1] 

机构地区：[1]广东省东莞市中山大学附属东华医院功能科,523110

出　　处：《临床超声医学杂志》2005年第4期260-262,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的根据早早孕子宫内膜声像特征,预测受精卵着床位置,指导妇科早期用药物终止妊娠,提高药物流产成功率,减轻病人痛苦。方法对361例尿HCG阳性、弱阳性患者进行阴道超声检查,子宫内未见孕囊长出,根据子宫内膜声像特点将内膜分为四型:其中Ⅰ型137例,Ⅱ型148例,Ⅲ型67例,Ⅳ型9例。Ⅰ、Ⅱ、Ⅲ型共352例给予药物终止妊娠。结果随诊340例,328例B超见子宫内膜清晰、居中,厚度3～6mm;12例宫内回声异常,其中7例见孕囊结构,5例见不均质较强回声团。尿HCG阴转329例。药物流产成功率96.8%,失败率3.2%,无并发症。结论B超能准确预测受精卵着床部位,指导临床早期用药物终止妊娠,安全可靠,成功率高。Objective To predicate the nidation position of fertilized ovum and guide termination of pregnancy with medicine according to ultrasonic character of uterine membrane of very early pregnancy by transvaginal ultrasound, to increase the successful rate of medicinal abortion, and reduce patient＇s pain. Methods Transvaginal ultrasotmd was performed on 361 women whose urine HCG were positive or weak positive. Embryo sacs were not seen in their uterine cavities.The uterine membrane was divided into 4 types： type 1 /type 2/type 3/type 4 according to ultrasonic characters. All the patients in type 1. type 2, and type 3 were given medicine to terminate pregnancy. Results Three himdred and forty patients were followed up, the uterine membranes were clear , middle and with the thickness from 3mm to 6mm. Abnormal echo in their uterine cavities were seen in 12 patients. Embryo sacs were seen in 7 patients , and inhomogeneous high echo lump could be seen in 5 patients. The urine HCG changed to negative in 329 patients. The successful rate of medicinal abortion was 96.8%, while missing rate was 3.2 % There was no complication. Conclusion B- Model ultrasotmd could be applied to exactly predicate the position of fertilized ovum and guide termination of pregnancy with medicine. This method is safe and reliable with high successful rate.

关 键 词：经阴道超声 着床 早早孕终止妊娠 子宫内膜 药物流产 早早孕 超声观察 临床 受精卵着床位置 经阴道 

分 类 号：R711.6[医药卫生—妇产科学] R169.42[医药卫生—临床医学]