经阴道彩色多普勒超声检查在药物流产方面的应用观察

Application Value of Transvaginal Ultrasound with Color Doppler Imaging in Drug Abortion

目的探讨经阴道彩色多普勒超声检查在药物流产方面的应用价值。方法通过对800例药物流产者药物流产前对孕囊周血流进行观察,测量RI值,观察血流量多少。对药流2周后仍流血不止的患者,又行经阴道彩色多普勒超声检查,对宫内见残留物且有血流信号者施行清宫并作病理检查,自愿观察者行药物治疗。结果800例药物流产者孕囊周均探及血流信号,有81例出现药物流产2周后仍流血不止,其中78例可探出宫内异常回声团(强回声、混合回声、弱回声),71例伴有血流信号,对有残留物而且伴有血流信号者62例予以清宫治愈;9例自愿选择口服药剂,其效果欠佳,最终清宫处理,余7例残留物无血流信号者口服药物后组织物排出,出血停止,3例仅显示子宫稍大,应用宫缩剂及抗炎治疗,血流停止。对比81例药流后流血不止者与720例药流完全者的孕囊周血流RI值差异无显著性。结论TVS-CD对药物流产后阴道出血时间延长患者寻找原因及临床处理有重要指导意义。孕囊周血流信号的存在,对确定孕囊在宫内与否有重要意义,对预测药流后反复出血无明显提示意义。

Objective To explore the application value of transvaginal ultrasound with color Doppler imaging （TVS-CD） in drug abortion. Methods 800 patients were examined by TVS-CD before drug abortion to observe the surrounding blood flow of gestational sac and measure the RI value. The patients who still had bleeding ＇after drug abortion for 2 weeks were examined by TVS-CD again. If intrauterine reminder with blood flow signal could be found, intrauterine curettage and pathological biopsy was performed, or medicine therapy was taken voluntarily. Results 800 patients after drug abortion showed blood flow signal after drug abortion showed blood flow siginal around the gestatingal sac. Amoung 81patients who had bleeding after drug abortion for 2 weeks. 78 cases showed abnormal echoes （strong echoes, mixed echoes, weak echoes ）and 71 cases showed blood flow signal together,of all the patients who had intrauterine remainder with blood flow siglal,62 cases were be cured with intrauterine curettage. 9 cases choosed oral medicine roluntarily hut the effect was not so good, finally they accepted intrauterine curettage. Of all the patients who had intrauterine remainder without blood flow signal, 7 cases discharged the tissues and bleeding stopped after taking oral medicine, 3 cases showed a bigger uterine and bleeding stopped after taking uterotomic and anti-infective. Compared 81 cases who kept bleeding after drug abortion with 720 cases that drug abortion completed, there was no significant difference in RI value of blood flow around gestational sac eordasion. Conclusion TVS-C has the important significance for finding the causes of prolonged vaginal bleeding after drug abortion and clinical treatment. The existence of blood flow signal around gestational sac is helpful to determine the existence of intrauterine gestational sac but no help to predict repeatedly bleeding after drug abortion.