宫腔操作术后宫腔粘连影响因素、超声表现及其诊断效果  

Influencing factors of the intrauterine adhesions after intrauterine operation and the diagnostic efficacy of the ultrasonic manifestations

作　　者：吴俐俐 陈宏丽 程琳[1] WU Lili;CHEN Hongli;CHENG Lin(Zhoushan Branch,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Zhoushan,Zhejiang Province,316012)

机构地区：[1]上海交通大学医学院附属瑞金医院舟山分院,316012

出　　处：《中国计划生育学杂志》2023年第7期1660-1664,共5页Chinese Journal of Family Planning

摘　　要：目的:探究宫腔操作术后发生粘连的影像表现及粘连发生影响因素,分析超声诊断效果。方法:回顾性分析2018年10月—2022年10月本院收治的40例宫腔操作术后发生宫腔粘连患者为观察组,术后未发生粘连的40例为对照组,均接受二维超声及宫腔镜检查,分析两组超声影像表现及超声诊断效果,多因素logistic分析患者术后发生宫腔粘连因素。结果:两组在边界是否清晰、占位大小、内部回声是否均匀、宫腔回声厚度等方面均有差异(P<0.05)。以宫腔镜检查为金标准,观察组40例患者经超声诊断为宫腔粘连32例,准确率为80.0%;漏诊8例,漏诊率为20.0%。观察组行宫腔镜及超声诊断,两种诊断方法对宫腔粘连分级结果无差异(P>0.05),以宫腔镜诊断为金标准,二维超声对轻重、中度、重度粘连诊断准确率分别为66.7%、92.3%、88.9%。多因素分析,患者存在宫腔操作史、刮宫史、人工流产史、人工流产≥2次、息肉数量为宫腔操作术后发生宫腔粘连的影响因素。结论:二维超声对宫腔操作术后宫腔粘连诊断准确率及分级诊断效果较好,对存在宫腔粘连的危险因素患者临床应予以重视。Objective:To explore the image appearance and the influencing factors of intrauterine adhesions after intrauterine operation,and to analyze the diagnostic value of ultrasound for intrauterine adhesions.Methods:40patients with intrauterine adhesions after intrauterine operation in the observation group and 40patients without intrauterine adhesions after intrauterine operation in the control group from October 2018to October 2022were analyzed retrospectively.All these patients had accepted the two-dimensional ultrasound and the hysteroscopic examinations.The ultrasound imaging performance of the patients in two groups and the diagnostic value of ultrasound for their intrauterine adhesions were analyzed.Multivariate logistic analysis was analyzed the influencing factors of intrauterine adhesions of the patients.Results:There were significantly differences in the distinct of boundary,the size of lesions,the uniform internal echo,and the thickness in uterine cavity echo of the patients between the two groups(P<0.05).Based on the hysteroscopic results as the gold standard,32of 40patients in the observation group were diagnosed with uterine adhesions by ultrasound,with the accuracy rate of 80.0%,and 8cases were missed diagnosis,with the missed diagnosis rate of 20.0%.The patients in the observation group had accepted diagnosis by both hysteroscopy and ultrasound,and there was no significant difference in the results of intrauterine adhesion classification of the patients between the two methods(P>0.05).Base on the hysteroscopic diagnosis as the gold standard,the accuracy of the two-dimensional ultrasound diagnosis for the mild,the moderate,and the severe adhesions of the patients were 66.7%,92.3%,and 88.9%,respectively.Multivariate analysis showed that the history of intrauterine operation,the history of curettage,the history of induced abortion,the induced abortion≥2times,the polyp>6pieces of the patients were the influential factors for the reoccurrence of their intrauterine adhesions after intrauterine operation.Co

关 键 词：宫腔操作 宫腔粘连 超声表现 诊断价值 影响因素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711[医药卫生—诊断学]