经阴道三维超声影像表现对流产后患者宫腔粘连程度诊断和治疗效果评估的价值

Diagnosis of intrauterine adhesions in patients after abortion by three-dimensional transvaginal ultrasound imaging and evaluation of therapeutic effect

目的探究经阴道三维超声(3 D-TVS)影像表现对流产后患者宫腔粘连程度诊断和治疗效果评估的价值。方法前瞻性选取2019年1月至2021年1月文昌市人民医院诊治的120例宫腔粘连患者作为研究对象,设为观察组。另选取120例进行健康体检的志愿者作为对照组。比较两组及宫腔粘连不同严重程度患者的子宫内膜容积(EV)､血管指数(VI)､血流指数(FI)及血管血流综合指数(VFI)。分析EV､VI､FI､VFI及联合检测对宫腔粘连的诊断效能。结果观察组的EV､VI､FI及VFI均显著低于对照组,差异具有统计学意义(P<0.05);治疗无效患者的EV､VI､FI及VFI均显著低于有效患者,差异具有统计学意义(P<0.05);宫腔粘连不同严重程度患者的EV､VI､FI及VFI比较,差异具有统计学意义(P<0.05);EV､VI､FI､VFI联合检测对宫腔粘连的诊断特异度显著高于EV､VI､FI､VFI单独检测;EV､VI､FI､VFI联合检测对宫腔粘连的受试者工作特征(ROC)曲线下面积显著高于EV､VI､FI､VFI单独检测。结论3D-TVS影像表现对流产后患者宫腔粘连程度的诊断及对治疗效果的评估均具有一定的临床价值。

Objective To explore the three-dimensional transvaginal ultrasound(3D-TVS)imaging performance in the diagnosis of intrauterine adhesions in patients after abortion and the evaluation of treatment effect.Methods A total of 120 patients with intrauterine adhesions diagnosed and treated in Wenchang People′s Hospital from January 2019 to January 2021 were prospectively selected as the study group.Another 120 healthy volunteers were selected as the control group.The endometrial volume(EV),vascular index(VI),blood flow index(FI)and vascular blood flow index(VFI)of the two groups and patients with different severity of intrauterine adhesions were compared.To analyze the diagnostic efficiency of EV,VI,FI,VFI and combined detection for intrauterine adhesions.Results EV,VI,FI and VFI in the observation group were significantly lower than those in the control group(P<0.05).EV,VI,FI and VFI in invalid patients were significantly lower than those in effective patients(P<0.05).EV,VI,FI and VFI of patients with different severity of intrauterine adhesions showed statistically significant differences(P<0.05).The diagnostic specificity of EV,VI,FI,VFI combined detection for intrauterine adhesions was significantly higher than that of single detection.EV,VI,FI,VFI combined detection had significantly higher area under ROC curve for intrauterine adhesions than that of single detection.Conclusions 3D-TVS imaging is of great significance in the diagnosis of intrauterine adhesions after abortion and the evaluation of treatment effect.