经阴道彩色多普勒超声对药物流产后阴道出血时间延长的观察分析.doc

经阴道彩色多普勒超声对药物流产后阴道出血时间延长的观察分析 【关键词】药物流产 ［摘要］ 目的：探讨药物流产后阴道出血时间延长者的宫腔声像图特征。 方法:对药物流产后阴道出血达15d的20例患者行经阴道彩色多 普勒超声检查，并与手术、病理检查结果对比。结果：20例中3 例内膜层内无明显血流信号，宫腔刮出物均为细碎组织物，其中 1例病理检查提示为少量坏死蜕膜伴有少量凝血块和大量炎症细 胞，2例为少量增生期内膜；17例内膜层内有明显血流信号，宫 腔刮出物均有陈旧性组织物，病理检查均见到滋养细胞和螺旋动 脉。结论：底蜕膜组织残留是药物流产阴道出血时间延长的主 要原因。 ［关键词］药物流产；经阴道彩色多普勒超声；子宫螺旋动脉; 阴道出血 ［中图分类号］R714.21; R445. 1 Study on uterine cavity sonogram of irregular vaginal bleeding over 15 days after medical abortion by transvaginal color doppler sonography LI Ling, ZHANG Chimin, LI Jia, SU Jun (Department of Ultrasound, Zhongda Hospital, Southeast University, Nanjing 210009, China) Abstract: Objective To investigate the uterine cavity sonogram of irregular vaginal bleeding over 15 days after medical abortion by transvaginal sonography. Methods From July to November 2003, in Zhongda Hospital of Southeast University, a study of uterine cavity sonogram was performed in 20 normal pregnancies with irregular vaginal bleeding over 15 days after medical abortion? Transvaginal color Doppler energy and pulsedwave Doppler technique were used as routine sonography scanning modalities? The hemodynamic parameters of uterine spiral arteries (SA), including peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI), pulsation index (PI), and systolic/diastolic velocity ratio(S/D) , were measured before and after abortion? On day 15, all subjects were performed D C and the resuIts were compared to those of pathology. Results For 3 women, no retained tissue and no spiral arteries signals were detected? For 17 women, retained tissue and spiral arteries signals were detectable. 2 cases were confirmed as complete abortion by surgery and pathology, 18 cases were confirmed as incomplete abortion by surgery and pathology. Conclusions Basal deciduas retained may be the most important factor effecting the abortion. Key words： medical abortion; transvaginal color Doppler sonography: uterine spiral arteries； vaginal bleeding 由于心理上的可接受性和对再次妊娠影响小等诸