经阴道彩色多普勒血流成像检查在先兆流产中的诊断效能及相关参数分析

Diagnostic efficacy and related parameter analysis of transvaginal color Doppler flow imaging in threatened miscarriage

目的:探讨经阴道彩色多普勒血流成像(CDFI)检查在先兆流产中的诊断效能及其相关参数。方法:选取2020年8月—2023年8月淄博市周村区妇幼保健院收治的先兆流产患者45例为观察组,另选同期健康妊娠孕妇45例为对照组,均行经阴道CDFI检查,比较两组黄体、子宫动脉及螺旋动脉血流,并绘制受试者工作特征(ROC)曲线分析各指标及联合检查诊断先兆流产的临床价值;比较保胎成功与保胎失败患者黄体、子宫动脉及螺旋动脉血流搏动指数(PI)、阻力指数(RI)差异。结果:观察组黄体、子宫螺旋动脉PI、RI高于对照组,差异有统计学意义(P<0.05);绘制ROC曲线显示,黄体、子宫螺旋动脉PI、RI及联合检测诊断先兆流产的AUC值分别为0.762、0.856、0.833、0.847、0.980,联合诊断价值最高;45例先兆流产患者中,保胎成功32例,保胎失败13例;保胎成功患者黄体、子宫螺旋动脉PI、RI低于保胎失败患者,差异有统计学意义(P<0.05)。结论:经阴道CDFI检查在先兆流产诊断中价值高,可明确黄体、子宫螺旋动脉血流变化,提高诊断准确性,便于早期开展保胎治疗,降低流产风险。

Objective To explore the diagnostic efficacy and related parameter of transvaginal color Doppler flow imaging(CDFI)in threatened miscarriage.Methods A total of 45 patients with threatened abortion admitted to Zibo Zhoucun Maternal and Child Health Hospital from August 2020 to August 2023 were selected as the observation group,and 45 healthy pregnant women during the same period were selected as the control group,transvaginal CDFI was performed to compare the blood flow of luteum,uterine artery and spiral artery between the two groups,and receiver operating characteristic(ROC)curve was drawn to analyze each index and the clinical value of combined examination in diagnosing threatened miscarriage.The difference of pulsatility index(PI)and resistance index(RI)in corpus luteum,uterine artery and spiral artery was compared between successful and failed patients.Results PI and RI of luteum and spiral artery of uterus in observation group were higher than those in control group,and the difference was statistically significant(P<0.05).ROC curve showed that the AUC values of corpus luteum,spiral artery of uterus PI,RI and combined detection in diagnosing threatened abortion were 0.762,0.856,0.833,0.847 and 0.980,respectively,and the combined diagnosis value was the highest.Of the 45 patients with threatened miscarriage,32 were successfully saved and 13 failed.Luteum,spiral artery PI and RI of uterus were lower in the patients with successful pregnancy preservation than in the patients with failed pregnancy preservation,and the difference was statistically significant(P<0.05).Conclusion Transvaginal CDFI has high value in the diagnosis of threatened miscarriage.It can clarify the changes in blood flow of the corpus luteum and uterine spiral artery,improve diagnostic accuracy,facilitate early fetal protection treatment,and reduce the risk of miscarriage.