經陰道三維超聲測定宮腔容積與血流變化在宮腔粘連患者診斷中的價值

徐春園 麻科 陳靜 劉亦專

【摘要】 目的：探討經陰道三維超聲診斷宮腔粘連患者宮腔容積與血流變化的臨床價值。方法：選擇2016年1月-2019年1月在筆者所在醫院進行診斷的宮腔粘連患者總共63例作為本次的研究對象，將其作為研究組;同時選擇同一時期內體檢正常的女性總共63例作為本次研究的對照組;兩組均給予經陰道三維超聲診斷，記錄并比較兩組的診斷結果、子宮內膜厚度、宮腔形態、宮腔容積及相關血流變化情況。結果：研究組共含有宮腔粘連患者63例，其中Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型宮腔粘連患者分別為19、29、9及3例，僅有3例患者未發現宮腔粘連現象，準確率為95.24%（60/63）;研究組及對照組相比，前組的宮腔容積平均值顯著低于后組（P<0.05）;前組的VFI、VI及FI水平均顯著低于后組（P<0.05）。結論：對宮腔粘連患者使用經陰道三維超聲診斷能夠發現其宮腔容積比正常女性小，同時相關的血流變化參數存在較大程度的下降，在臨床過程中使用經陰道三維超聲診斷做出的評價比較客觀，可以廣泛使用。

【關鍵詞】 經陰道三維超聲 宮腔容積 宮腔粘連 血流變化

doi：10.14033/j.cnki.cfmr.2020.02.027 文獻標識碼 B 文章編號 1674-6805（2020）02-00-03

[Abstract] Objective： To investigate the clinical value of transvaginal three-dimensional ultrasound in the diagnosis of uterine cavity volume and blood flow changes in patients with intrauterine adhesions. Method： A total of 63 patients with intrauterine adhesions who diagnosed in our hospital from January 2016 to January 2019 were selected as the study group， and 63 women with normal physical examination in the same period were selected as the control group. Two groups of patients were given transvaginal three-dimensional ultrasound diagnosis， recording and comparing the two groups of diagnosis results， endometrial thickness， uterine cavity shape， uterine cavity volume and related blood flow changes. Result： There were 63 cases of intrauterine adhesions in the study group， of which 19 cases were type Ⅰ， 29 cases were type Ⅱ， 9 cases were type Ⅲ and 3 cases were type Ⅳ. Only 3 cases had no intrauterine adhesions， and the accuracy rate was 95.24% （60/63）. Compared with the control group， the average volume of uterine cavity in the study group was significantly lower （P<0.05）. Compared with the control group， the levels of VFI， VI and FI in the study group were significantly lower （P<0.05）. Conclusion： Using transvaginal three-dimensional ultrasound to diagnose uterine adhesions can find that the volume of endometrium is smaller than that of normal women. At the same time， the related parameters of blood flow change decrease to a large extent. The evaluation made by transvaginal three-dimensional ultrasound in clinical process is objective and can be widely used.

[Key words] Transvaginal three-dimensional ultrasound Uterine cavity volume Uterine cavity adhesion Blood flow changes

First-authors address： Fusha Hospital of Zhongshan City， Zhongshan 528434，China

在臨床醫學中，宮腔粘連屬于比較常見的婦科疾病，該疾病別稱為Asherman綜合征[1]，導致其出現的原因包括所有會使子宮內膜受到破壞的因素。該疾病的特征一般為存在腹痛、月經異常及無法生育等[2]。對宮腔粘連患者進行準確的診斷和有效治療可以較好地提高預后。如今臨床使用子宮輸卵管造影、宮腔鏡對宮腔粘連進行診斷，雖然有較高的宮內疾病診斷準確率，但是由于該方法存在價格貴、不易操作、時間耗費多及有創傷等缺點，很難全面推廣使用。經陰道三維超聲可以對患者病變宮腔的病理變化進行檢測，由于該方法能夠建立子宮內膜的三維數據庫，故檢測結果更加完善合理[3]。本文為了探討在宮腔粘連患者的診斷過程中應用經陰道三維超聲的診斷價值，選擇了筆者所在醫院相關的研究對象進行研究，取得了非常理想的成果，相關報道見下文。