超声对医源性子宫壁损伤诊断价值.docVIP

超声对医源性子宫壁损伤诊断价值 　　 　　[摘要] 目的 评价二维超声及彩色多普勒超声对医源性子宫壁损伤的诊断价值及临床意义。 方法 2006年1月～2013年6月在本院或其他医院有过宫腔操作手术病史，临床和超声诊断子宫壁穿透性或非穿透性宫壁损伤的患者37例，对其声像特征进行总结分析。 结果 11例子宫壁穿透性损伤中有2例伴网膜嵌顿，9例无网膜嵌顿；26例非穿透性宫壁损伤，其中22例单纯非穿透性宫壁损伤患者宫壁有异常丰富的血流区，2例为黏膜下积液，2例为黏膜下血肿。 结论 子宫穿孔超声诊断准确率高，非穿透性子宫壁损伤临床症状轻，其血流丰富型的宫壁损伤声像图表现与滋养细胞肿瘤和胚胎组织残留及宫腔内、输卵管间质部、子宫峡部瘢痕处妊娠光团型稽留流产相似，必须仔细检查，并结合病史、血β-HCG进行鉴别诊断，必要时定期随访、复查，从而减少误诊，避免再次行清宫术，减少患者的痛苦与恐慌。 　　[关键词] 二维超声；彩色多普勒超声；医源性损伤；子宫壁穿透性损伤；子宫壁非穿透性损伤 　　[中图分类号] R81[文献标识码] A[文章编号] 1674-4721（2014）04（c）-0102-04 　　 　　Ultrasound in the diagnosis of iatrogenic injury of uterine wall 　　DONG Ying-mei TANG Li CHAI Mei LIAO Xue-fen YAN Xian-bo 　　Department of Function,Shipai People′s Hospital of Dongguan City in Guangdong Province,Dongguan 523330,China 　　[Abstract] Objective To evaluate the diagnostic value and clinical significance of B-ultrasound and color Doppler ultrasound for iatrogenic injury of uterine wall. Methods 37 cases of patients with penetrating or non- penetrating injury of uterine wall diagnosed by clinical and ultrasound,which had surgery history of uterine surgery from January 2006 to June 2013 in our hospital or other hospitals.The patients′ ultrasound imaging characteristics were analyzed. Results 11 cases of penetrating uterine wall injury,of which 2 cases had complication of omentum incarceration while other 9 cases not.26 cases of non-penetrating uterine wall injury,of which 22 patients′ uterine wall had abnormal blood rich area,2 cases had submucosal effusion and 2 cases had submucosal hematoma. Conclusion Ultrasound has a high accuracy in the diagnosis of uterine perforation.Clinical symptoms of patients with non-penetrating uterine wall injury are mild and its sonographic feature of blood-rich area in uterine wall is similar with those in patients with trophoblastic tumor,embryonic tissue residue and missed abortion occurred in the uterine cavity,interstitial tubal or scars of uterine isthmusin.Therefore,doctors should examine the patients carefully and ma