不同残留物类型药物流产不全的经阴道超声特征研究  

Study on transvaginal ultrasound characteristics of incomplete abortion caused by different types of residual drugs

作　　者：丁延华 李迎华 赵丽燕 姚继芹 DING Yanhua;LI Yinghua;ZHAO Liyan;YAO Jiqin(Department of Ultrasound and Electrocardiogram,Hangzhou Obstetrics and Gynecology Hospital,Hangzhou,Zhejiang 310008,China)

机构地区：[1]杭州市妇产科医院超声心电科,浙江杭州310008 [2]杭州市妇产科医院妇科

出　　处：《中华全科医学》2025年第3期468-471,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2025KY1178)。

摘　　要：目的探讨药物流产不全患者不同残留物类型的经阴道超声特征差异,以评估其用于指导药物流产不全治疗方案制定的临床价值。方法选取2022年1月-2024年6月于杭州市妇产科医院就诊并接受治疗的150例药物流产不全患者为研究对象,根据病理检查结果,以残留物类型不同分为绒毛膜蜕膜组(109例)和非绒毛膜蜕膜组(41例),对全部研究对象进行经阴道超声检查,观察不同类型药物流产不全残留物在形态、回声信号、血流分布及血流动力学等超声特征方面的差异情况。结果绒毛膜蜕膜组出现子宫体积增大患者比例显著高于非绒毛膜蜕膜组(P<0.05),且绒毛膜蜕膜残留物以团块形为主,而非绒毛膜蜕膜残留物则以片形为主。绒毛膜蜕膜残留物超声信号以低回声和混合回声为主,而非绒毛膜蜕膜残留物超声信号以强回声为主(P<0.001)。绒毛膜蜕膜组患者残留物血流丰富比例(89.91%,98/109)显著高于非绒毛膜蜕膜组(9.76%,4/41),差异有统计学意义(χ^(2)=87.961,P<0.001)。绒毛膜蜕膜组患者药物流产后残留物血流搏动指数(PI)和阻力指数(RI)分别为0.86±0.13、0.61±0.09,均显著低于非绒毛膜蜕膜组(1.47±0.21、0.74±0.11,P<0.001)。结论不同类型药物流产不全残留物在形态、回声信号、血流分布及血流动力学等超声特征方面均存在差异,经阴道超声检查在指导药物流产不全治疗方式选择方面具有较高应用价值。Objective To investigate the differences in transvaginal ultrasound characteristics among different types of residues in patients with incomplete medical abortion,and to evaluate their clinical value in guiding the development of individualized treatment strategies.Methods A total of 150 patients with incomplete medical abortion who received treatment at Hangzhou Obstetrics and Gynecology Hospital from January 2022 to June 2024 were selected as the research subjects.Based on pathological examination results,the residual materials were divided into two groups:the chorionic decidua group(109 cases)and the non-chorionic decidua group(41 cases).Transvaginal ultrasound examination was performed on all study subjects to assess the differences in ultrasound characteristics,including morphology,echo signal,blood flow distribution,and hemodynamics between the two groups.Results The proportion of patients with increased uterine volume in the chorionic and decidua group was significantly higher than that in the non-chorionic decidua group(P<0.05).The residual of chorionic decidua group mainly presented as the form of lumps,while the residual of non-chorionic decidua mainly appeared as the form of patches.The ultrasound signals of residual chorionic decidual tissue were mainly hypoechoic and mixed echogenic,while the ultrasound signals of non-residual chorionic-decidual tissue were mainly hyperechoic signals(P<0.001).The proportion of residual blood flow signals in the chorionic decidua group(89.91%,98/109)was significantly higher than that in the non-chorionic decidua group(9.76%,4/41),with a statistically significant difference(χ^(2)=87.961,P<0.001).The pulsatility index(PI)and resistance index(RI)of residual blood flow after medical abortion in the chorionic decidua group were 0.86±0.13 and 0.61±0.09,respectively,which were significantly lower than those in the non-chorionic decidua group(1.47±0.21 and 0.74±0.11,P<0.001).Conclusion Significant differences were observed in ultrasound characteristics,including morpholo

关 键 词：药物流产 残留物 经阴道超声 血流动力学 诊断 治疗 

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]