经阴道三维超声评估宫腔粘连松解术后患者子宫内膜价值  

Value of transvaginal three-dimensional ultrasound for evaluating the endometrium situation of infertility patients with intrauterine adhesions

作　　者：龙凤 张海英 LONG Feng;ZHANG Haiying(Reproductive Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi Zhuang Autonomous Region,530021;Jiangbin Hospital of Guangxi Zhuang Autonomous Region)

机构地区：[1]广西壮族自治区生殖医院,南宁530021 [2]广西壮族自治区江滨医院

出　　处：《中国计划生育学杂志》2023年第2期420-423,F0003,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨应用经阴道三维超声(3D-TVS)对不孕症合并宫腔粘连(IUA)患者评估子宫内膜情况及体外受精-胚胎移植(IVF-ET)妊娠结局的关系,为临床提供影像学依据。方法:回顾性分析2016年6月-2018年12月在本院因输卵管因素拟行IVF-ET治疗且经宫腔镜确诊IUA的不孕患者共98例临床资料及超声影像学资料,患者均行宫腔镜下宫腔粘连松解术(TCRA)并在术后1年内行IVF-ET治疗,根据妊娠结局分为临床妊娠组55例和未妊娠组43例,分析两组胚胎种植窗期子宫内膜厚度、类型及3D-TVS声像图表现。结果:临床妊娠组与未妊娠组内膜厚度[(8.40±1.33)mm(5.8~11.5mm)、(7.83±1.69)mm(4.8~11.7mm)]、内膜类型比较无差异(均P>0.05)。3D声像图异常比例临床妊娠组与未妊娠组(3.6%、20.9%)有差异(P<0.05),未妊娠组的3D-TVS声像图异常主要表现为内膜局限性暗区、内膜局部缺损区。结论:对于不孕症合并IUA患者,3D-TVS可以准确评估宫腔和内膜异常回声改变,为IVF-ET治疗及预后提供重要信息。Objective: To explore the value of transvaginal three-dimensional ultrasound(3D-TVS) for evaluating the endometrium situation of infertility patients with intrauterine adhesions(IUA), and to study the correlation between the endometrium situation of the infertility patients and their pregnancy outcomes after in vitro fertilization embryo transfer(IVF-ET). Methods: The clinical data and the ultrasonic imaging data of 98 infertile patients with IUA who had accepted IVF-ET were analyzed retrospectively. All the patients had undergone hysteroscopic transvaginal resolution of adhesions(TCRA) and had received IVF-ET within 1 year after operation. According to the pregnancy outcomes, these patients were divided into group A(55 cases with clinical pregnancy) and group B(43 cases without pregnancy). The endometrial thickness and type, and the ultrasonogram by 3D-TVS during the implantation window of the patients in the two groups were analyzed. Results: There were no significant differences in the endometrial thickness [(8.40±1.33)mm(5.8-11.5mm) vs.(7.83±1.69)mm(4.8-11.7mm)] and the endometrial type of the patients between the two groups(all P>0.05). There was significant difference in the proportion of the normal sonogram by 3D-TVS 3D(3.6% vs. 20.9%) of the patients between the two groups(P<0.05). The abnormal sonogram by 3D-TVS 3D of the patients in group B were mainly manifested as endometrial limitation dark area and endometrial local defect area. Conclusion: D-TVS can accurately evaluate the abnormal echo changes of uterine cavity and endometrium of the infertility patients with IUA, which can provide important information for IVF-ET and the prognosis of infertility patients with IUA.

关 键 词：不孕症 宫腔粘连 宫腔粘连松解术 体外受精-胚胎移植 经阴道三维超声 子宫内膜 声像图特征 

分 类 号：R445.1[医药卫生—影像医学与核医学] R713.4[医药卫生—诊断学]