经阴道超声测量子宫宫腔团块的厚度和体积诊断不全流产的价值.docVIP

经阴道超声测量子宫宫腔团块的厚度和体积诊断不全流产的价值 　　[摘要] 目的 评估采用超声测量方法诊断临床怀疑不全流产患者宫腔残留妊娠物的应用价值。 方法 回顾性分析2013年1月～2015年6月在我院临床怀疑不全流产并行清宫术的患者共145例，经阴道超声测量子宫内异常回声团块的厚度及体积，清宫术后的组织送病理学检查。对比研究宫内异常回声团块的厚度、体积与病理学结果的相关性。 结果 145例患者中，102例（70.3%）病理学检测发现绒毛膜组织，43例（29.7%）仅发现蜕膜组织。未发现有意义的团块厚度或体积的参考值，可以用来区分妊娠残留物和蜕膜组织。 结论 超声测量子宫内异常团块的厚度或体积，不是诊断不全流产的有效指标。 　　[关键词] 不全流产；妊娠残留物；超声；子宫内膜 　　[中图分类号] R445.1 [文献标识码] B [文章编号] 1673-9701（2016）15-0084-03 　　[Abstract] Objective To access the applicable value of diagnosing retained products of conceptions（RPOC） by transvaginal ultrasonography in 145 women with clinical diagnosis of incomplete miscarriage. Methods A retrospective study was performed to analyze the data in 145 female patients treated during the period from Jan 2013 to June 2015.These women were suspected that there were retained tissue in uterus after incomplete miscarriage.The measurement of endometrial thickness and volume were acquired by transvaginal ultrasonography. And all the tissues in uterus were for pathological examination. The relationship among endometrial thickness， volume and pathological examination were analyzed. Results Among 145 patients，the pathological results of 102（70.3%） were chorionic villi，while the left 43 （29.7%） were decidua.There was no identifiable cut-off value of endometrial thickness and volume that could be used to differentiate retained products of conception and decidua. Conclusion Ultrasound parameters of endometrial thickness and volume are not good diagnostic marker for diagnosing an incomplete miscarriage. 　　[Key words] Incomplete miscarriage； Retained products of conceptions； Ultrasound； Endometrium 　　不全流产是妇科最常见的疾病之一。超声在诊断不全流产中发挥着重要作用，也是对其采取保守治疗还是手术治疗的重要指征之一。有研究采用测量子宫内异常团块厚度的方法用来诊断妊娠残留物（retained products of conception，RPOC）。目前还没有公认的异常团块厚度的截断值可以作为诊断不全流产的标准。本研究的目的通过对比超声和刮宫术后组织病理结果，探讨能否找到理想的子宫内异常团块的厚度或体积的截断值，作为超声诊断不全流产的标准。 　　1 资料与方法 　　1.1 一般资料 　　选择2013年1月～2015年6月在我院就诊、临床怀疑不全流产并行清宫术患者145例。平均年龄31岁（19～41岁）。已婚95例，未婚50例。其中85例患者孕2产1，10例患者孕1产0，50例患者怀孕次数超过3次，生产次数0～