彩色多普勒超声诊断技术在宫腔粘连患者不同治疗方法评估中的效果分析  

Analysis on the effect of color Doppler ultrasound diagnostic technique on assessing the different therapeutic methods for patients with intrauterine adhesion

作　　者：张学术[1] 张加盟 曹淑新[3] 李翠[2] 宋智慧 张惠娟[2] ZHANG Xue-shu;ZHANG Jia-meng;CAO Shu-xin(Outpatient of Gynecology Department,Beijing Maternal and Child Health Care Hospital,Tangshan 063000,China)

机构地区：[1]唐山市妇幼保健院妇科门诊,河北唐山063000 [2]唐山市妇幼保健院优生遗传科,河北唐山063000 [3]唐山市妇幼保健院产科,河北唐山063000

出　　处：《中国医学装备》2022年第10期88-92,共5页China Medical Equipment

基　　金：河北省2020年度医学科学研究课题(20201486)“不孕症患者慢性子宫内膜炎诊断方法比较及高危因素分析”。

摘　　要：目的:基于彩色多普勒超声诊断仪检测子宫动脉血流参数,探讨宫腔镜联合激素序贯疗法在治疗宫腔粘连的临床价值。方法:选取妇幼保健院收治的140例宫腔粘连所致不孕患者,均行宫腔镜分离宫腔粘连的手术治疗,按照术后治疗方案不同,将其分为对照组和观察组,每组70例。对照组术后采用常规治疗,观察组术后行雌孕激素序贯治疗,对比分析两组患者三维能量多普勒血管造影(3D-PDA)诊断中子宫动脉血流参数、月经恢复情况以及妊娠情况。结果:治疗后两组患者的子宫动脉阻力指数(RI)、搏动指数(PI)较治疗前均降低,且观察组低于对照组,差异有统计学意义(t=3.217,t=9.895;P<0.05);两组患者的子宫内膜厚度值、子宫内膜体积(EV)和血管血流指数(VFI)测定值均较治疗前显著增高,且观察组高于对照组,差异有统计学意义(t=3.398,t=2.917,t=3.932;P<0.05);观察组治疗后的经期持续时间长于对照组、月经量多于对照组,差异有统计学意义(t=3.628,t=3.628;P<0.05);观察组再次妊娠率高于对照组,再次发生宫腔粘连率低于对照组,差异有统计学意义(x^(2)=5.833,x^(2)=4.904;P<0.05)。结论:宫腔镜联合激素序贯疗法可改善子宫动脉血流及内膜的容受性,提高妊娠率及改善月经状态,采用3D-PDA技术可有效评估宫腔粘连患者的治疗效果。Objective: To explore the clinical value of hysteroscopy combined with sequential hormone therapy in treating intrauterine adhesions based on the detection of color Doppler ultrasound on blood flow parameters of uterine artery. Methods: 140 patients who were infertility caused by intrauterine adhesions and were treated in the Maternal and Child Health Hospital were selected. All of them were treated by hysteroscopy to separate intrauterine adhesions.According to different post-operative treatment plans, they were divided into control group and observation group,with 70 cases in each group. Routine treatment was used in control group after operation, and sequential treatment with estrogen and progesterone was used in observation group after operation. The blood flow parameters of uterine artery, the recovery of menstruation and pregnancy in the diagnosis of three-dimensional power Doppler angiography(3D-PDA) between two groups were compared and analyzed. Results: The resistance index(RI) and pulsatile index(PI) of uterine artery in the two groups after treatment were significantly lower than those before treatment, and those of observation group was significantly lower than them of control group(t=3.217, t=9.895, P<0.05). The endometrial thickness, uterine endometrial volume(EV) and vascularity flow index(VFI) values of the two groups after treatment were significantly higher than those before treatment, and those of observation group were significantly higher than those of control group, and the differences of them between the two groups were statistically significant(t=3.398,t=2.917, t=3.932, P<0.05), respectively. The duration of menstrual period and menstrual volume after treatment in observation group were significantly longer and larger than those in control group(t=3.628, t=3.628, P<0.05),respectively. The recurrence rate of pregnancy in observation group was significantly higher than that in control group, and the recurrence rate of intrauterine adhesion in observation group was significantly lower than th

关 键 词：彩色多普勒超声 三维能量多普勒血管造影(3D-PDA) 雌孕激素 序贯疗法 宫腔粘连 宫腔镜 

分 类 号：R445.1[医药卫生—影像医学与核医学]