宫腔粘连患者经阴道彩色多普勒超声血流参数变化及其诊断价值分析

Changes of transvaginal color Doppler ultrasound blood flow parameters in patients with intrauterine adhesions and their diagnostic value

目的:探讨宫腔粘连(IUA)患者彩色多普勒超声血流参数变化及其诊断价值分析.方法:回顾性选取我院2018年11月~2021年1月收治的81例IUA患者为观察组,并收集同一时期接受体检的健康女性70例为对照组,入组患者均行经阴道彩色多普勒超声,分别记录两组内膜容积(EV)、内膜血管指数(VI)、血流指数(FI)及血管血流综合指数(VFI),并根据内膜厚度将观察组进行分组,比较不同分组之间的血流参数差异,分析其在疾病诊断中的价值.结果:观察组EV、VI、FI、VFI均低于对照组,差异具有统计学意义;81例患者中轻度28例,其影像学特征以子宫内膜线部分不连续、宫腔内少量粘连、内膜厚度>5mm等为主,中度36例,其影像学特征以子宫内膜线部分不连续、宫腔内多处纤维状或膜状粘连、内膜厚度2~5mm等为主,重度17例,其影像学特征以子宫内膜线不连续、完全粘连、管腔积血、内膜厚度<2mm为主;不同分组之间血流参数比较也具有统计学差异,即EV越小其VI、FI、VFI越低;经Pearson相关性分析显示,IUA患者EV与VI、FI、VFI成明显正相关.结论:IUA患者超声血流参数与正常人相比均呈低表达,且不同分型的患者血流参数也不同,因此临床可通过经阴道彩色多普勒超声观察宫腔内膜容积及血流变化情况,其对于临床诊断具有重要参考价值.

Objective To investigate the changes of color Doppler ultrasound blood flow parameters in patients with intrau-terine adhesions(IUA),and analyze their diagnostic value.Methods 81 patients with IUA(observation group)and 70 healthy women(control group)were enrolled in this study between January 2019 and January 2021.All patients enrolled underwent transvaginal color Doppler ultrasound.The endometrial volume(EV),endometrial vascular index(VI),endometrial flow index(FI)and endometrial vascular flow index(VFI)were recorded.Patients in the observation group were grouped according to the endometrial thickness,and blood flow parameters were compared between the groups.The diagnostic value of these blood flow parameters was analyzed.Results The EV,VI,FI and VFI in the observation group were lower than those in the control group.Among the 81 patients,there were 28 patients with mild IUA whose imaging features mainly included some discontinuous en-dometrial lines,few intrauterine adhesions and endometrial thickness>5mm,36 patients with moderate IUA whose imaging features mainly included some discontinuous endometrial lines,multiple fibrous or membranous adhesions in the uterine cavity and endometrial thickness of 2-5 mm,and 17 patients with severe IUA whose imaging features included discontinuous en-dometrial lines,complete adhesions,luminal hematocele and endometrial thickness<2 mm.The blood flow parameters showed statistical differences between the groups.The smaller the EV,the lower the VI,FI and VFI.Pearson correlation analysis found that the EV was significantly positively correlated with VI,FI and VFI in patients with IUA.Conclusion Compared with normal people,patients with IUA have lower ultrasound blood flow parameters,and the blood flow parameters are different in patients with different types of disease.Clinically,changes of endometrial volume and blood flow can be observed by transvaginal color Doppler ultrasound to provide reference for clinical diagnosis.