早期异位妊娠子宫内膜阴道超声下形态及其与病理类型的相关性

Relationship between endometrial pattern of early ectopic pregnancy detected by transvaginal ultrasound and pathological types

目的:运用阴道超声(TVS)观察早期异位妊娠患者的子宫内膜形态,探讨阴道超声下的子宫内膜形态与其病理类型的关系。方法:回顾性分析55例早期异位妊娠患者TVS下的子宫内膜厚度、形态类型、对称性等,并与42例宫内早早孕相对照,其中31例早期EP患者行诊刮术。比较TVS下内膜"三线征"与早期EP病理类型的关系。结果:①EP组子宫内膜厚度比宫内早孕薄(P<0.01),70.9%的EP患者内膜厚度≤9mm,89.1%呈对称增厚,69.1%呈A型内膜("三线状"改变),与宫内早孕组相比差异均有显著性意义(P<0.01)。②子宫内膜病理结果为蜕膜样组织、蜕膜组织和A-S反应、晚期增殖期的病例出现A型内膜的比例较高,但它们之间没有相关性。结论:阴道超声下子宫内膜形态可以作为鉴别诊断早期EP的有价值指标之一,对预测、鉴别早期EP有一定意义。

Objective： To observe the endometrial pattern of early ectopic pregnancy detected by transvaginal ultrasound, discuss the relationship with pathological types. Methods： The endometrial pattern of 55 patients with early ectopic pregnancy and 42 patients （31 patients undergoing endocervical curettage ） with early intrauterine pregnancy were analyzed retrospectively, such as endometrial thickness, endometrial pattern and endometrial symmetry, the relationship between the trilaminar pattern and the pathological types was analyzed. Results： ①Endometrial thickness in early ectopic pregnancy group was thinner than that in early intrauterine pregnancy group （P 〈 0. 01 ） . The proportions of endometrial thickness ≤9 mm （70. 9% ） symmetric thickening endometrium （89. 1% ） and type A endometri- um（ trilaminar pattern） （69. 1% ） in early ectopic pregnancy group had significantly difference with those in early intrauterine pregnancy group （ P 〈 0. 01 ） .② Higher percentage of type A endometrimn was detected in these patients with the pathological finding of decidual - like tissue, decidual tissue and A - S reaction and late period of proliferation, but there was no relation between them. Conclusion： Endometrial pattern by transvaginal ultrasound can be a valuable sign for the diagnosis of early ectopic pregnancy and plays a role in the prediction of the disease.