药物流产后子宫持续出血的超声表现与病理相关性

Significance of ultrasound features in prolonged vaginal bleeding after medical termination of early pregnancy

目的探讨药物流产后子宫持续出血患者的超声声像图特征及其与病理的相关性。方法对95例药物流产后两周以上仍有子宫出血的患者同时行经腹及经阴道超声检查,观察宫腔内膜、宫内残留物及双侧附件区情况。95例清宫术后标本均行病理组织学检查。结果药物流产后子宫持续性出血患者的声像图特征及清宫组织病理表现:(1)超声显示为宫内小片状高回声32例,清宫组织中见少量坏死的蜕膜组织残留;(2)宫内团块样回声32例,清宫组织中有变性蜕膜及绒毛组织残留,部分绒毛向肌壁侵蚀;(3)宫内小孕囊样回声5例,清宫组织中见变性蜕膜组织;(4)子宫内膜粗糙7例,清宫组织为增殖期宫内膜,为完全流产后内膜修复性改变;(5)卵巢无回声区7例,宫内残留物病理检查为少量蜕膜组织;(6)宫内团块伴宫腔内积液12例,宫内残留物病理检查见子宫内膜炎细胞浸润。结论药物流产后子宫出血时间延长患者的声像图特征与病理表现有一定相关性,超声检查可为药物流产后子宫持续出血患者的临床治疗提供诊断依据。

ObjectiveTo investigate the relationship between the clinical and the ultrasound features in prolonged vaginal bleeding after medical termination of early pregnancy.MethodsNinety-five cases who still had prolonged bleeding over two weeks after drug abortion underwent transvaginal sonography (TVS) and transadominal sonography (TAS) to observe the situation of intrauterine residue and adnexa. ResultsThe characteristic sonographic features in 95 cases could be shown as six different types:(1)intrauterine thin hyperechoic slices;(2)intrauterine echogenic mass;(3)intrauterine small sac;(4)the endometrial roughness;(5)a saclike structures in ovary;(6)intrauterine echogenic mass with fluid collection.ConclusionsBy studying the ultrasound features in prolonged vaginal bleeding after medical termination of early pregnancy, it is shown that TVS pocessess important significance for finding the causes of prolonged vaginal bleeding after drug abortion and for instructing the clinical treatment.