3D-PDU对宫腔粘连术后妊娠结局的预测  

Predictive of 3D-PDU for pregnancy outcome after intrauterine adhesions surgery

作　　者：谢继平[1] 陈琳琳[1] 朱光 金林熙 XIE Jiping;CHEN Linlin;ZHU Guang;JIN Linxi(Department Gynecology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,Zhejiang,China;Hangzhou Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China)

机构地区：[1]浙江省立同德医院妇科,浙江杭州310012 [2]浙江中医药大学杭州临床医学院,浙江杭州310053

出　　处：《中国现代医生》2024年第27期34-37,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2020ZB055)。

摘　　要：目的探讨经阴道三维能量多普勒超声(three-dimensional power Doppler ultrasound,3D-PDU)对轻、中度宫腔粘连松解术(transcervical resection of adhesion,TCRA)后妊娠结局的预测价值。方法选取2020年1月至2021年12月于浙江省立同德医院行TCRA治疗并有生育要求的66例轻、中度宫腔粘连(intrauterine adhesions,IUA)患者,其中31例成功妊娠患者纳入妊娠组,35例未成功妊娠患者纳入非妊娠组。患者于术前及术后3个月行3D-PDU检测,获得子宫内膜厚度(endometrial thickness,ED)、宫腔容积(uterine volume,EV)、子宫内膜血管生成指数(vasculogenesis index,VI)、血流指数(blood flow index,FI)、血管生成-血流指数(vasculogenesis-blood flow index,VFI)。随访术后1年患者的受孕情况,观察上述相关指标对术后妊娠结局的预测价值。结果术后患者的ED、EV、VI、FI、VFI较术前明显改善(P<0.05),且妊娠组患者的改善情况优于非妊娠组(P<0.05);受试者操作特征曲线下面积分别为0.80、0.84、0.68、0.65、0.88。结论3D-PDU通过测量轻、中度IUA患者手术前后的ED、EV、VI、FI、VFI可有效预测TCRA术后患者的妊娠结局,为疗效评估及指导后续治疗提供参考依据。Objective To assess the efficacy of transvaginal three-dimensional power Doppler ultrasound(3D-PDU)in predicting pregnancy outcomes after mild and moderate transcervical resection of adhesion(TCRA).Methods Sixty-six patients with mild and moderate intrauterine adhesions(IUA)who had fertility issues and underwent TCRA surgery in Tongde Hospital of Zhejiang Province from January 2020 to December 2021 were chosen,31 successful pregnancy patients were included in pregnancy group,and 35 unsuccessful pregnancy patients were included in non pregnancy group.3D-PDU examination was performed before and 3 months after surgery.The measurements of endometrial thickness(ED),uterine volume(EV),endometrial vasculogenesis index(VI),blood flow index(FI),and vasculogenesis-blood flow index(VFI)were taken.The pregnancy was followed up for 1 year to observe the prognostic value of the above related indicators on postoperative pregnancy.Results The ED,EV,VI,FI and VFI levels of patients post-operation were significantly higher than those before the operation(P<0.05),the improvement of pregnant group patients was better than that of non pregnant group patients(P<0.05),and area under the receiver operating characteristic curve were 0.80,0.84,0.68,0.65 and 0.88 respectively.Conclusion 3D-PDU can effectively predict the postoperative pregnancy outcome of TCRA in patients with mild to moderate IUA by measuring ED,EV,VI,FI,and VFI before and after surgery,providing reference for efficacy evaluation and guiding subsequent treatment.

关 键 词：宫腔粘连 三维超声 宫腔镜 子宫内膜血流 宫腔容积 妊娠 

分 类 号：R711.4[医药卫生—妇产科学]