缩宫素对子宫良性病变滋养血管频谱变化的超声观察

Oxytocin caused nutrient artery wavement changes of myometrial lesions by ultrasound

目的超声观察子宫肌瘤及局限性子宫腺肌病应用缩宫素前后滋养动脉频谱形态变化,评价肌层良性病变子宫对缩宫素的反应。方法子宫肌瘤(30例)及局限性子宫腺肌病(15例)静滴缩宫素(0.04U/min)前后行彩超检查,对比滋养动脉频谱形态变化。结果应用缩宫素后,子宫肌瘤(24/30)及局限性子宫腺肌病(10/15)出现异型频谱,包括单向楔形、单向圆钝、双向楔形及热带鱼样等;子宫肌瘤及局限性子宫腺肌病频谱变化包括异型持续(19/30,6/15)、异型交替(5/30,4/15)、正常舒缩变化(6/30,5/15);不同类型肌瘤周边与内部动脉均出现频谱变化;所有患者子宫弓状动脉与双侧子宫动脉均未检测到频谱变化。结论多普勒超声检测滋养动脉频谱形态变化有助于评价肌层良性病变子宫对缩宫素的反应;异型频谱的出现可能是由于子宫肌层收缩导致滋养血管发生狭窄或痉挛。

Objective To assess the response of uterine myometrium to oxytocin. Methods Thirty pa- tients （mean age 39.77 ± 4.34 years） with uterine fibroids and 15 patients （mean age 36.27±4.54 years） with focal adenomyosis underwent Doppler ultrasound to observe the nutrient artery waveform for 30 min before and after intravenous injection of oxytocin （0.04 U/min）. Results After applying oxytocin, abnormal waveforms were seen in 24 patients with uterine fibroids （80%） , as well as in 10 patients with focal adenomyosis （66.7%）, including monophasic-wedged, monophasic-domed, biphasic-wedged, or tropical fish-like. Waveform changes could be categorized into two types, i. e. , bizarre waveforms such as persistent change （ 19/30, 6/15） and alternative change （5/30, 4/15） ; and normal waveforms like velocity change （6/30, 5/15）. Different formwave changes appeared in the periphery and internal artery of all different types of uterine fibroids. We did not observe any waveform changes in uterine areuate artery and bilateral uterine artery. Conclusion Doppler ultrasound waveform changes of nutrient artery are useful for evaluating the response to oxytocin in uterine myometrium. Abnormal waveforms may be caused by myometrial contraction that leads to nutrient artery stenosis or spasm.