超声鉴别诊断妊娠子宫局限性收缩与妊娠合并子宫肌壁间肌瘤的作用研究

Application Study of Ultrasound in the Diagnosis and Identification of Limitations Pregnant Uterus Contraction and Intramural Uterine Fibroids

目的：探讨超声诊断妊娠子宫局限性收缩与妊娠合并子宫肌壁间肌瘤的作用。方法：选择2011年7月-2012年7月本院妇产科诊治的妊娠子宫局限性收缩患者30例为观察组，妊娠合并子宫肌瘤患者30例为对照组，所有患者均经手术或超声随访观察确诊。所有患者均于入院后3 d内完成超声检查。使用GE公司生产的VOLUSON 730彩色多普勒超声诊断仪，采用多普勒技术测量病变内阻力指数（RI）。比较妊娠子宫局限性收缩与妊娠合并子宫肌瘤超声学特征，包括部位、数量、形态、边缘、回声特征、包膜及内部血流特征等。结果：子宫肌瘤位于宫底3例，宫体27例，中下段10例；单发21例，多发9例；呈类圆形，1-2 h后复查超声形态无变化；边界清晰，周围可见假包膜；呈均匀性低回声，其中5例伴有强回声光点；对邻近结构呈压迫改变，内可见点状血流，其RI为（0.55±0.04）。子宫局限性收缩均位于宫体，中下段16例；单发26例，多发4例；呈类圆形，1-2 h后复查超声形态明显变化或消失；边界不清，周围无假包膜；呈等或略低回声，胎盘边缘呈唇样改变；内无血流信号，其RI为（0.82±0.08），两者比较差异有统计学意义。结论：在妊娠子宫局限性收缩与妊娠合并子宫肌壁间肌瘤鉴别诊断中，超声具有很高的价值。

Objective： To investigate the applications value of ultrasound in the diagnosis of pregnant uterus with limitations contraction and uterus with intramural fibroids.Method： Thirty patients with uterine contractions limitations were chosen as the observation group, and 30 patients with uterine fibroids were chosen as the control group. All patients were confirmed by surgery or ultrasound follow-up observation. Ultrasound examinations were performed within 3 days after admission. The ultrasound characteristics were compared, including the location, number, shape, edge, echo characteristics, envelope and internal flow characteristics. Result： The group of uterine fibroids had 3 cases in the fundus, 27 cases were located in the Palace, of which the lower segment had 10 cases, and single 21 cases and multiple 9 cases; The review of ultrasound morphology after 1-2 hours showed no change; The lesion had clear boundaries, and pseudocapsule can be seen. The RI was（0.55 ± 0.04）. The group of limitations uterine contractions all located in the palace, where the middle and lower sections had 16 cases, single 26 and multiple 4; The review showed significant changes after 1-2 hours with ultrasonographic changes or disappearance. There were no blood flow signals. The RI was（0.82 ± 0.08）. The difference was statistically significant between the two groups in RI（P〈0.05）.Conclusion： In the diagnosis of pregnant uterus contraction limitations and intramural uterine fibroids during pregnancy, ultrasound showed high value.