超声弹性测量评估宫颈成熟度在足月妊娠促宫颈成熟中的临床价值  

Theclinicalvalue of elastography in predicting the outcome of Dinopstonelabour induction

作　　者：赵蕾[1] 陈佩文[2] 林莹[1] 陈菲菲[1] 肖梅[1] Zhao Lei;Chen Peiwen;Lin Ying;Chen Feifei;Mei Xiao(Hubei Maternity and Child Health Hospital,Wuhan 430070,Hubei,China)

机构地区：[1]湖北省妇幼保健院产科,湖北武汉430070 [2]湖北省妇幼保健院超声诊断科,湖北武汉430070

出　　处：《中国产前诊断杂志（电子版）》2020年第2期45-49,共5页Chinese Journal of Prenatal Diagnosis(Electronic Version)

基　　金：湖北省卫生计生委2018年度第二批联合基金项目(WJ2018H0172)。

摘　　要：目的前瞻性研究足月妊娠引产前采用超声弹性成像评估宫颈成熟度的临床价值。方法单胎、头位、足月妊娠的147例孕妇在宫颈后穹隆放置地诺前列酮栓促宫颈成熟前,超声弹性测量子宫颈矢状面上硬度比(hardness ratio)、宫颈内口应变平均值(internal cervical os,IOS)、宫颈外口应变平均值(external cervical os,EOS)、IOS/EOS比值(Ratio)及宫颈长度数值。分析宫颈弹性测量数值、内诊Bishop评分与引产成功率的关系。结果引产成功105例,成功率71.42%,其中顺产96例,剖宫产9例;促宫颈成熟后未临产42例,其中置药24小时未临产,取药后拒绝继续引产直接剖宫产30例,取药后加用缩宫素引产失败12例。临产组和未临产组年龄、孕周、分娩前体质指数均无差异,引产前二组手法Bishop评分差异无统计学意义。对比两组内的彩超弹性测量数值发现:临产组孕妇的宫颈内口和外口的弹性具有一致性,无统计学差异(0.3108±0.093 vs 0.3031±0.108,t=0.659,P=0.511>0.05),未临产孕妇的宫颈内口较外口硬(0.368±0.112 vs 0.326±0.091,t=2.57,P=0.015<0.05,差异有显著性)。两组之间比较宫颈弹性测量数值发现:未临产组孕妇宫颈内口(IOS)较临产者硬(0.368±0.112 vs 0.311±0.093,t=2.810,P=0.009<0.05),而两组EOS无统计学差异。结论手法Bishop评分法结合超声宫颈弹性成像,对预测促宫颈成熟起到了规范化、标准化的作用,能预测引产成功率。宫颈弹性测量是手法Bishop评分法的客观补充指标。Objective To perform a preliminary investigation into the use of elastography for cervical assessment,in order to determine the effectiveness of this method for the evaluation of cervical consistency.Methods Elastography of the uterine cervix andmanual Bishop score was performed in 147 patients before induction of labor,with tissue surrounding the internal os described using a numeric scale called the elastography index(EI),for example hardness ratio,EI of internal cervical os(IOS),EI of external cervical os(EOS),ratio of IOS/EOS and cervical length.The EI of tissue around the internal os,and around the external os were analyzed in relation to the success of induction of labor using the t-test.Results 105 cases were successful in induced labor;the rate was 71.42%,including 96 cases of spontaneous labor,9 cases of cesarean section.42 cases failed active labor,including 30 cases of direct cesarean section after taking out medicine.As shown in Table 1,there were no differences in age,gestational weeks and body mass index before delivery between successful and unsuccessful induced labor groups.Comparing the Bishop score of two groups of pregnant women,it was found that there was no significant difference between the two groups.Comparing the color Doppler ultrasound elasticity measurements of the two groups,it was found that the elasticity of the cervical opening and the cervical opening of pregnant women with successful induction of labor was consistent,but there was no significant difference(0.3108±0.093 vs 0.3031±0.108,t=0.659,P=0.511<0.05),and the pregnancy with failed induction In women,not only the elasticity of the cervical inner mouth was harder than that of the successful induced labor,but also the elasticity of the inner mouth was higher than that of the inner mouth(t=2.57,P=0.015<0.05,the difference was significant).There was no statistical difference in the elasticity of the external cervical os measured by cervical color Doppler ultrasonography between the two groups(P>0.05),which was consistent with th

关 键 词：弹性测量 引产 足月妊娠 宫颈 

分 类 号：R445.1[医药卫生—影像医学与核医学]