实时阴道超声检查在人工流产术中的应用效果及对患者术后子宫内膜修复周期监测价值研究

Application effect of real-time vaginal ultrasound in artificial abortion and its value in monitoring the postoperative endometrial repair cycle

目的:探究实时阴道超声在人工流产术中的应用效果及对术后子宫内膜修复周期的监测价值。方法:收集人工流产术患者246例,其中134例在实时阴道超声引导下行人工流产术(观察组),112例行传统人工流产术(对照组),记录两组手术相关指标(手术时间、术中出血量、术后阴道出血时间)、围术期并发症发生情况;并将观察组根据术后月经恢复情况分为月经不调组及月经正常组,比较两组术后2、4、6周阴道超声检测指标[子宫内膜厚度、子宫动脉搏动指数(PI)、阻力指数(RI)]。结果:观察组手术时间、术中出血量、术后阴道出血时间及围术期并发症总发生率均低于对照组(均P<0.05)。134例观察组患者中49例纳入月经不调组,85例纳入月经正常组;两组术后子宫内膜厚度及子宫动脉PI组内比较,均为术后2周<术后4周<术后6周(均P<0.05),且月经不调组术后各时间点子宫内膜厚度均低于月经正常组(P<0.05),而术后各时间点子宫动脉PI均高于月经正常组(P<0.05);两组术后子宫动脉RI比较,均为术后2周>术后4周>术后6周(P<0.05),且月经不调组术后各时间点子宫动脉RI均高于月经正常组(P<0.05)。结论:实时阴道超声可提高人工流产术操作准确性及安全性,还能辅助评估患者术后子宫内膜修复情况,在人工流产术围术期中应用价值较高。

Objective:To explore the application effect of real-time vaginal ultrasound in artificial abortion and its value in monitoring the postoperative endometrial repair cycle.Methods:246 cases of patients were collected,of which 134 cases underwent artificial abortion under the guidance of real-time vaginal ultrasound(observation group),112 cases underwent traditional artificial abortion(control group).The two groups of operation-related indicators(operation time,intraoperative blood loss,postoperative vaginal bleeding time),perioperative complications were recorded.The observation group was divided into irregular menstruation group and normal menstruation group based on postoperative menstrual recovery,and the vaginal ultrasound detection indexes[endometrial thickness,uterine artery pulsation index(PI),resistance index(RI)]2,4,6 weeks after operation were compared between the two groups.Results:The operation time,intraoperative blood loss,postoperative vaginal bleeding time and the total incidence of perioperative complications in the observation group were lower than those in the control group(all P<0.05).Among 134 patients in observation group,there were 49 cases in irregular menstruation group and 85 cases in normal menstruation group.Comparison of endometrial thickness and uterine artery PI in the two groups showed that 2 weeks after surgery<4 weeks after surgery<6 weeks after surgery(all P<0.05),and the endometrial thickness in irregular menstruation group at each time point after surgery was lower than that in normal menstruation group(all P<0.05),and the uterine artery PI at each time point after surgery was higher than that in normal menstruation group(all P<0.05).Comparison of uterine artery RI in the two groups showed that 2 weeks after surgery>4 weeks after surgery>6 weeks after surgery(all P<0.05),and the uterine artery RI at each time point after surgery in irregular menstruation group was higher than that in normal menstruation group(all P<0.05).Conclusion:Real-time vaginal ultrasound can improve the accuracy and safety of artificial abortion,and can also help to evaluate the postoperative endometrial repair of patients.It is of high application value in the perioperative period of artificial abortion.