经直肠双平面超声评估育龄期妇女宫颈锥切术后宫颈的变化  

Transrectal biplane ultrasound assessment of cervical changes in reproductive-age women post-conization

作　　者：张源 吴丹 王文平 杨惠惠 冯小雪 ZHANG Yuan;WU Dan;WANG Wen-ping;YANG Hui-hui;FENG Xiao-xue(Ultrasound Department,the Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing Jiangning Hospital,Nanjing 211100,Jiangsu,China)

机构地区：[1]南京医科大学附属江宁医院、南京市江宁医院超声科,江苏南京211100

出　　处：《广东医学》2024年第9期1143-1148,共6页Guangdong Medical Journal

基　　金：江苏省中医药管理项目(JD2023S218);江宁区惠民发展计划项目(2023060S)。

摘　　要：目的应用经直肠双平面超声评估育龄期妇女宫颈锥切术后宫颈状态。方法采用回顾性研究,选取2021年4月至2023年10月在医院行宫颈锥切术的高级别宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)患者102例作为观察组,另选取同期体检宫颈的50例正常育龄期妇女作为对照组。对照组(体检时)和观察组(术后6、12、18个月)均行经直肠双平面超声检查,测量宫颈长度、宫颈体积及宫颈内外口硬度值,对比宫颈状态差异,分析观察组术后宫颈状态变化。结果无论是观察组还是对照组,宫颈内口(前唇、后唇)的硬度值均高于宫颈外口(前唇、后唇),差异均有统计学意义(P<0.05);观察组内术后6、12、18个月间的宫颈长度及宫颈体积对比,差异均无统计学意义(P>0.05)。观察组宫颈内外口的硬度值在术后6个月高于术后12个月,硬度值差异有统计学意义(P<0.05),术后18个月与12个月硬度值对比,差异无统计学意义(P>0.05)。与对照组比较,观察组内93例患者术后6个月宫颈内外口硬度值高于对照组,术后12个月和18个月宫颈内外口硬度值与对照组对比,差异无统计学意义(P>0.05);观察组内9例宫颈硬度值与对照组相比,术后6、12、18个月硬度值均高于对照组(P<0.05)。结论宫颈锥切术患者术后宫颈长度可基本恢复,宫颈硬度亦可基本恢复,但部分患者宫颈长度恢复了,弹性值增加,经直肠双平面超声可作为一项评估宫颈状态变化的理想工具。Objective To assess cervical status in reproductive-age women post-conization using transrectal biplane ultrasound.Methods A retrospective study was conducted,selecting 102 patients who underwent cervical conization for high-grade cervical intraepithelial neoplasia(CIN)at the hospital between April 2021 and October 2023 as the observation group.Additionally,50 age-matched healthy women undergoing routine cervical examination were selected as the control group.Both groups underwent transrectal biplane ultrasound to measure cervical length,volume,and hardness of the internal and external cervical os at 6,12,and 18 months post-operation in the observation group and during routine check-ups in the control group.Differences in cervical status were compared,and changes in the observation group were analyzed over time.Results In both groups,the hardness values at the internal cervical os(anterior and posterior lips)were significantly higher than at the external cervical os(anterior and posterior lips)(P<0.05).There were no statistically significant differences in cervical length and volume between the observation group at 6,12,and 18 months post-operation and the control group(P>0.05).However,the hardness of the cervical os in the observation group was significantly higher at 6 months post-operation compared to 12 months(P<0.05),but no significant differences were found between 12 and 18 months(P>0.05).When comparing the observation group with the control group,93 patients in the observation group had significantly higher cervical os hardness at 6 months post-operation compared to the control group,while no significant differences were observed at 12 and 18 months(P>0.05).However,9 patients in the observation group exhibited higher hardness values at 6,12,and 18 months compared to the control group(P<0.05).Conclusion Post-conization,cervical length generally returns to normal,and cervical hardness also recovers in most patients.However,some patients experience increased elasticity despite the recovery of cervical length

关 键 词：宫颈锥切术 经直肠双平面超声 宫颈上皮内瘤变 宫颈硬度值 

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]