经腹与经阴道彩色多普勒超声诊断药物流产后宫腔内残留异常效果  

Effect of transvaginal and transabdominal color Doppler ultrasound for diagnosing abnormalities of residur in the uterine cavity after medical abortion

作　　者：罗敏亚 潘群颖 吕利 LUO Minya;PAN Qunying;LV Li(Xinchang County Hospital of Traditional Chinese Medicine,Xinchang,Zhejiang Province,312500)

机构地区：[1]浙江省新昌县中医院,312500

出　　处：《中国计划生育学杂志》2023年第10期2413-2416,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨彩色多普勒超声(CDU)经腹或经阴道检查,对早孕药物流产后子宫腔内残留异常诊断价值。方法:回顾性收集2019年3月-2022年3月本院收治的100例早孕药物流产后子宫腔内有残留物患者,均行经腹及经阴道CDU检查,以宫腔镜组织病理检查结果作为金标准,比较两种超声检查对流产后宫腔内残留物诊断符合率。结果:经腹CDU检查,子宫内膜厚度<1.2cm占比(9.0%)低于经阴道CDU检查(20.0%),存在子宫内膜血流信号(73.0%)低于经阴道CDU检查(88.0%),血流阻力指数>0.5占比(12.0%)低于经阴道CDU检查(27.0%),宫腔内有异常回声(74.0%)低于经阴道CDU检查(89.0%),高回声所占比(40.0%)低于经阴道CDU检查(55.0%)(均P<0.05)。病理检查显示,100例中有90例宫腔内残留物存在异常;经腹CDU检出80例,诊断符合率为84.4%;经阴道CDU检出91例,诊断符合率为98.9%,两种检查方法有差异(χ^(2)=5.853,P=0.016)。Kappa检验显示,与病理检查一致性经腹CDU诊断较差(Kappa=0.308)、经阴道CDU一致性良好(Kappa=0.826)。结论:经阴道CDU能清晰显示宫腔内残留组织的大小、部位、血流情况及回声情况,对流产后子宫腔内残留物异常的诊断准确性较高。Objective:To explore the value of the examinations of transvaginal and transabdominal color Doppler ultra-sound(CDU)for diagnosing the residue abnormalities in the uterine cavity of patients after medical abortion duringearly pregnancy.Methods:1o0 patients with uterine cavity residues after medical abortion during early pregnancy fromMarch 2019 to March 2022 were collected as subjects retrospectively.All these patients had undergone the examina-tions of transvaginal and transabdominal CDU.Based on the results of hysteroscopic histopathology as the gold stand-ard of diagnosing the uterine cavity residues,the coincidence rate of diagnosis of the uterine cavity residues was com-pared between the examinations of transvaginal and transabdominal CDU.Results:The transabdominal CDU examina-tion showed that the proportions of the endometrial thickness<1.2cm and the endometrial blood flow signal of the pa-tients were 9.0%and 73.0%,and which were significantly lower than those(20.0%and 88.0%)by transvaginal CDUexamination,The proportions of the blood flow resistance index>0.5,the abnormal echo in the uterine cavity,and thehigh echo in the uterine cavity of the patients by transabdominal CDU were 12.0%,74.0%,and 40.0%,respectivelyand which were significantly lower than those(27.0%,89.0%,and 55.0%,respectively)by transvaginal CDU examination.The pathological examination showed that 90 out of 1o0 patients had abnormal intrauterine residues,including80 patients with intrauterine residues were detected by transabdominal CDU,with the diagnosis coincidence rate of84.4%and 91 patients with intrauterine residues detected by transvaginal CDU,with the diagnosis coincidence rate of98.9%.There was significant difference in the diagnosis coincidence rate between the transabdominal CDU and thetransvaginal CDU(x-5.853,P=0.016).Kappa test showed that the diagnosis coincidence between the result of pathological examination and the results of the transabdominal CDU examination was poor(Kappa=0.308)and the di-agnosis coincidence between the re

关 键 词：药物流产 宫腔残留物 彩色多普勒超声 声像图分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R169.42[医药卫生—诊断学]