不同类型药物流产不全患者经阴道彩色多普勒超声特征分析

Application value of transvaginal color doppler scanning(TVCDS) on hemorrhage causes differentiation after drug abortion

目的:探讨经阴道彩色多普勒超声在药物流产后出血原因鉴别中的应用价值。方法:选择100例药物流产不全患者,均接受经阴道彩色多普勒超声检查,观察子宫大小、残留物形状、宫腔内残留物周边及内部血流情况,同时检测其血流阻力指数RI。所有患者均接受清宫治疗并对残留物进行病理活检,根据活检结果分为绒毛膜蜕膜组与非绒毛膜蜕膜组,回顾性分析两组彩色多普勒超声表现的差异。结果:绒毛膜蜕膜组子宫增大例数明显多于非绒毛膜蜕膜组(P<0.05);绒毛膜蜕膜组宫腔内残留物形状以团块状为主,而非绒毛膜蜕膜组以片状为主,两组比较具有统计学差异(P<0.01);绒毛膜蜕膜组宫腔内残留物周边及内部血流丰富例数明显多于对照组(P<0.01);绒毛膜蜕膜组宫腔内残留物血流阻力指数RI小于非绒毛膜蜕膜组(P<0.05)。结论:采用经阴道彩色多普勒超声能有效的鉴别药物流产后出血的原因,为临床治疗提供依据。

Objectives： To discuss the application value of transvaginal color doppler scanning（ TVCDS）on hemorrhage causes differentiation after drug abortion. Methods： 100 patients with incomplete drug abortion were given TVCDS,and the size of uterine,shape of residue,ambitus and interior bloodstream of residue in the uterinecavity were observed,and meanwhile,the resistance index（ RI） was detected as well. All the patients were given curettage treatment,whose residue were given biopsy,and were divided into chorion and deciduas group and non chorion and deciduas group in accordance with biopsy results. The differences expressed on Doppler scanning of patients in two groups were given retrospective analysis. Results： The cases of hysterauxesis in chorion and deciduas group were much more than that in non chorion and deciduas group（ P〈0. 05）. The shapes of residue of patients in chorion and deciduas group were mostly crumby structure,while the shapes of residue of patients in chorion and deciduas group were mostly schistose,and the statistical differences appeared on patients in two groups after comparison（ P〈0. 01）. The cases of rich ambitus and interior bloodstream of residue in the uterine cavity of patients in chorion and deciduas group were much more than those in control group（ P〈0. 01）. The RI of residue in the uterine cavity of patients in chorion and deciduas group were much lower than that in non chorion and deciduas group（ P 0. 05）. Conclusion： The application of TVCDS can effectively indentify hemorrhage causes differentiation after drug abortion,which can provide evidence for clinical medical treatment.