经阴道超声检查对宫腔术后子宫肌壁损伤的诊断价值

The value of transvaginal ultrasonography in the diagnosis of uterine wall injury after uterine cavity surgery

目的:探讨经阴道超声诊断宫腔术后子宫肌壁损伤及分型的临床价值。方法:对2016年1月至2020年12月在本院及其他医院进行过宫腔操作的127例患者经临床确诊的子宫肌壁损伤,分析其不同类型的阴道超声声像图结果。结果:宫腔操作术后子宫肌壁损伤的发生类型依次为子宫肌壁与基底层交界处损伤(黏膜后肌壁损伤)55例(43.0%),子宫肌壁血肿55例(30.0%),子宫肌壁创伤性动静脉瘘13例(10.0%),子宫穿孔4例(3.0%),不同病变类型的患者,其声像图特征及临床处置方法各异。结论:经阴道超声诊断是诊断宫腔术后子宫肌壁损伤直接有效的检查手段,可发现子宫肌壁损伤部位及范围并进行超声分型,并可评估子宫肌壁损伤严重程度及预后,可指导临床的治疗方案及作为随诊观察方法。

Objective:To explore the clinical value of transvaginal ultrasound in the diagnosis and classification of uterine wall injury after uterine cavity surgery.Methods:127 cases of Uterine Wall injury diagnosed clinically in our hospital and other hospitals from January 2016 to December 2020 were analyzed with different types of vaginal ultrasound images.Results:55 cases(43.0%)and 55 cases(30.0%)of myometrial wall injury(myometrial wall injury)occurred at the junction of myometrial wall and Basal Layer(myometrial wall injury),there were 13 cases(10.0%)of traumatic arteriovenous fistula in uterine wall and 4 cases(3.0%)of uterine perforation.The sonographic features and clinical management were different in patients with different pathological types.Conclusions:Transvaginal ultrasound is a direct and effective means to diagnose the uterine wall injury after uterine cavity surgery.The location and extent of theuterine wall injury can be found and classified by ultrasound,and the severity of the uterine wall injury can be assessed,it can guide clinical treatment plan and follow-up observation method.