多普勒超声监测早期先兆流产孕妇子宫螺旋动脉血流参数预测保胎预后效能  

Efficacy of the blood flow parameters of uterine spiral artery monitored by Doppler ultrasound of pregnant women with early threatened abortion for predicting their prognosis after fetal protection

作　　者：刘晓丹 金阳 申雨鑫 谭盼[2] LIU Xiaodan;JIN Yang;SHEN Yuxin;TAN Pan(Pengzhou People's Hospital,Pengzhou,Sichuan Provrince,611930;Jixi People's Hospital,Heilongjiang Province)

机构地区：[1]四川省彭州市人民医院,611930 [2]黑龙江省鸡西市人民医院

出　　处：《中国计划生育学杂志》2023年第11期2577-2581,2586,共6页Chinese Journal of Family Planning

摘　　要：目的:分析多普勒超声监测早期先兆流产孕妇子宫螺旋动脉血流情况及预后效能。方法:选择2019年7月-2021年12月本院就诊的98例早期先兆流产孕妇为观察组,同期产前检查正常孕妇98例为对照组。均接受经阴道彩色多普勒超声检查,比较两组入组时超声影像学特征、黄体形态、黄体血流超声指标及子宫螺旋动脉血流参数[阻力指数(RI)、搏动指数(PI)、收缩期最高流速与舒张最低流速比(S/D)];对观察组跟踪随访,根据保胎结局分为早孕流产组及保胎成功组,比较两亚组入组时子宫螺旋动脉血流参数;采用受试者工作曲线(ROC)分析上述子宫螺旋动脉血流参数对观察组保胎成功的预测价值。结果:超声检查观察组宫腔出血76.5%,孕囊位置正常35.7%,孕囊位于宫腔中下段64.3%,且孕囊外形正常或欠规则,子宫螺旋动脉血流频谱明显见舒张早期α切迹样改变,黄体形态为圆环形65.3%,棒状23.5%及点状11.2%,超声回声类型强回声57.1%,不均质低回声42.9%;对照组黄体形态均为圆环形,超声强回声86.7%。两组黄体形态及超声回声类型有差异(P<0.05)。观察组黄体血流RI、PI高于对照组,PSV低于对照组,入组时子宫螺旋动脉RI(0.58±0.04)、PI(0.80±0.05)、S/D(2.31±0.30)均高于对照组(0.46±0.03、0.64±0.06、1.95±0.23)(均P<0.05)。观察组实施保胎治疗后,保胎成功70例、早孕流产28例,保胎成功组入组时子宫螺旋动脉RI、PI、S/D值低于早孕流产组(均P<0.05)。ROC曲线分析,子宫螺旋动脉RI、PI、S/D对早期先兆流产孕妇保胎成功的单独预测效能(AUC=0.761、0.701、0.719)均低于3项联合诊断(AUC=0.835)。结论:子宫螺旋动脉血流参数可一定程度评估早期先兆流产孕妇的保胎结局,联合检测可提高诊断效能。Objective:To analyze the situation of the blood flow of uterine spiral artery monitored by Doppler ultrasound of pregnant women with early threatened abortion,and to study its efficacy for predicting the prognosis after fetal protection of the women.Methods:98 pregnant women with early threatened abortion were selected as observation group from July 2019 to December 2021,and another 98 pregnant women with normal obstetric examination during the same period were included in control group.All the women in the two groups were given transvaginal color Doppler ultrasonography examination.The ultrasonographic features,the corpus luteum morphology,the corpus luteum flow ultrasound indicators,and the blood flow parameters of uterine spiral artery,such as resistance index(RI),pulsatility index(PI),and ratio of the highest systolic flow velocity to the lowest diastolic flow velocity(S/D),of the women were compared between the two groups.The women in the observation group were followed up,and were divided into group A(women with early abortion)and group B(women with sucessful fetal protection)according to the status of the women after fetal protection treatment.The blood flow parameters of uterine spiral artery of the women were com-pared between group A and group B.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the blood flow parameters of uterine spiral artery of the women for the success of fetal protection treatment of the women with early threatened abortion.Results:In the observation group,the uterine bleeding rate of the women was 76.5%,and the rate of the gestational sac in normal position of the women was 35.7%.The rate of the gestational sac in the middle and lower part of the uterine cavity of the women in the observation group was 64.3%.The shape of the gestational sac of the women was normal or irregular,and the blood flow spectrum of the uterus spiral artery of the women showed obvious a-notch-like changes.The shape of the corpus luteum of the women in the observation g

关 键 词：先兆流产 多普勒超声 子宫螺旋动脉参数 影像特征 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.21[医药卫生—诊断学]