放置宫内节育器后子宫内膜螺旋动脉的三维空间形态  

ThreeDimensionalReconstructionofHumanEndometrialSpiralArteriesPreinsertionandPostinser┐tionofIUD

作　　者：黄丽丽[1,2,3] 陈凌钧[1,2,3] 陈湫波 章明[1,2,3] 赵承洛 汪国昭[1,2,3] 童若峰[1,2,3] 

机构地区：[1]浙江医科大学附属妇产科医院 [2]浙江大学数学系 [3]浙江医科大学解剖教研组

出　　处：《中华妇产科杂志》1996年第9期523-525,共3页Chinese Journal of Obstetrics and Gynecology

基　　金：国家八五攻关项目资助

摘　　要：目的：研究不同宫内节育器（ＩＵＤ）对子宫内膜螺旋动脉形态的影响，为防治出血副反应提供理论依据。方法：取未放置ＩＵＤ、放置ＴＣｕ２２０ＣＩＵＤ及放置γ消炎痛ＣｕＩＵＤ３个月后妇女各３例的分泌晚期子宫内膜，应用电子计算机三维重建技术，重建子宫内膜螺旋动脉。结果：未放置ＩＵＤ的子宫内膜，螺旋动脉的螺旋状盘曲较均匀，平均管径２２．６９μｍ，曲率０．９６，桡率１．２７；放置ＴＣｕ２２０ＣＩＵＤ后，螺旋动脉盘曲不均匀，呈团状网状迂曲，平均管径１７．９９μｍ，曲率１．４８，桡率１．８６；放置γ消炎痛ＣｕＩＵＤ后，螺旋动脉变化与放置前相似。结论：含铜ＩＵＤ影响子宫内膜螺旋动脉的发育成熟，而消炎痛能对抗之。利用计算机三维重建技术，可重建人子宫内膜螺旋动脉。Objective:Toinvestigatethemicro-threedimensionalchangesofendometrialspiralarteriesafterinsertionofdiferentintrauterinedevices(IUD).Methods:Nineendometriumspeci-menswereobtainedfromfertileagewomen:3frompreinsertion,3obtained3monthsafterinsertionofTCu220CIUD,and3specimensobtained3monthsafterinsertionofγCuIUD(releasingin-domethacin20μg/day).Alsampleswerecolectedinlatesecretoryphaseandweresectionedserial-ly.ByaTVcamera,theimagesofsectionsweresentfromalightmicroscopetoacomputerandcon-vertedintodigitaldata.Thespiralarteriesofendometriumwerereconstructedandvisualizedonaworkstationbymeansofthesoftwarepackageforthethreedimensionalreconstructionandvisualiza-tion.Thecurvatureandtorsionofthespiralarterieswerecalculated.Results:Inpreinsertiongroup,thespiralarteriescurvedregularlyinthreedimensions,andtheaveragediameterwas22.69μm,theaveragecurvaturewas0.96andtheaveragetorsionwas1.27.ThespiralarteriesofγCuIUDgrouphadsimilarappearancesasthepreinsertiongroup.However,inTCu220CIUDgroup,thecurveswereirregular,andtheaveragediameterwas17.99μm,theaveragecurvaturewas1.48andaveragetorsion1.86.Conclusion:Thethreedimensionalreconstructionofhumanendometrialspiralarterieswasdonebymeansofcomputerassistedreconstructiontechnologyforthefirsttime.Theendometri-umspiralarterieschangedinmorphologyafterinsertionofcopperIUD,andindomethacinmayhavecontraryefectsoncopper.

关 键 词：子宫内膜 宫内避孕器 子宫出血 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]