经直肠超声检查预测药物流产结局的研究

Research on the prediction of the outcome of medical abortion by transrectal ultrasonography

目的探讨经直肠超声在预测药物流产结局方面的临床应用价值。方法选择120例无任何合并症和并发症的药物流产妇女，于药物流产后第3天经直肠超声观察宫腔情况。根据宫腔内容物血流信号特征，分为Ⅰ、Ⅱ、Ⅲ型；根据宫腔内容物最大前后径，分为A（〈10．0mm）、B（11．0～30．0mm）和C（〉30．0mm）三组；并随访各组药物流产结局。结果Ⅰ、Ⅱ、Ⅲ型患者药流成功率依次为95．83％、31．03％、0；清宫率依次为0、17．24％及100％；A、B、C三组患者药流成功率依次为94．67％、3．03％、0；清宫率依次为0、2424％、100％，且各组间比较差异有统计学意义（P〈0．05）。此外，随着血流信号丰富程度的增加，宫腔内容物大小呈逐渐上升趋势，差异有统计学意义（P〈0．01）。结论应用直肠超声观测宫腔隋况对预测药物流产结局有一定的指导意义。对于宫腔内容物血流信号丰富且体积较大的药物流产患者，应加强监测，可积极行清宫术。

Objective To explore the value of transrectal uhrasonography in predicting the outcome of medical abortion. Methods One hundred and twenty women who received medical abortion without any complications were enrolled in the study. Transrectal uhrasonography was performed to observe the situation of uterine cavity three days after medical abortion. Subjects were divided into group Ⅰ , Ⅱ and Ⅲ according to the features of blood flow signal in uterine cavity contents. Subjects were divided into group A（ 〈 10.0 mm ）, B （ 11.0-30.0 mm） and C （〉30.0 mm） according to the maximum diameter of uterine cavity contents. The outcome of medical abortion in all groups was followed. Results The success rate of medical abortion of group Ⅰ , Ⅱ and m was 95.83%, 31.03% and 0, while the ratio of additional curettage was 0, 17.24% and 100% , respectively. By contrast, the success rate of medical abortion of group A, B and C was 94.67%, 3.03%, and 0, and the ratio of additional curettage was 0, 24.24% and 100%, respectively. There were significant differences among the groups （P〈0.05）. With the increase of the grades of blood flow signal, the maximum diameter of uterine cavity contents increased. There were significant differences（P〈0.01 ）. Conclusion Transrectal uhrasonography of uterine cavity is a valuable predictor for the outcome of medical abortion. For the patients received medical abortion with rich blood flow signal and big volume in uterine cavity contents, we should strengthen the monitoring and proceed a curettage actively.