徐春园 麻科 陈静 刘亦专

【摘要】 目的：探讨经阴道三维超声诊断宫腔粘连患者宫腔容积与血流变化的临床价值。方法：选择2016年1月-2019年1月在笔者所在医院进行诊断的宫腔粘连患者总共63例作为本次的研究对象，将其作为研究组;同时选择同一时期内体检正常的女性总共63例作为本次研究的对照组;两组均给予经阴道三维超声诊断，记录并比较两组的诊断结果、子宫内膜厚度、宫腔形态、宫腔容积及相关血流变化情况。结果：研究组共含有宫腔粘连患者63例，其中Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型宫腔粘连患者分别为19、29、9及3例，仅有3例患者未发现宫腔粘连现象，准确率为95.24%（60/63）;研究组及对照组相比，前组的宫腔容积平均值显著低于后组（P<0.05）;前组的VFI、VI及FI水平均显著低于后组（P<0.05）。结论：对宫腔粘连患者使用经阴道三维超声诊断能够发现其宫腔容积比正常女性小，同时相关的血流变化参数存在较大程度的下降，在临床过程中使用经阴道三维超声诊断做出的评价比较客观，可以广泛使用。

【关键词】 经阴道三维超声 宫腔容積 宫腔粘连 血流变化

doi：10.14033/j.cnki.cfmr.2020.02.027 文献标识码 B 文章编号 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

在临床医学中，宫腔粘连属于比较常见的妇科疾病，该疾病别称为Asherman综合征[1]，导致其出现的原因包括所有会使子宫内膜受到破坏的因素。该疾病的特征一般为存在腹痛、月经异常及无法生育等[2]。对宫腔粘连患者进行准确的诊断和有效治疗可以较好地提高预后。如今临床使用子宫输卵管造影、宫腔镜对宫腔粘连进行诊断，虽然有较高的宫内疾病诊断准确率，但是由于该方法存在价格贵、不易操作、时间耗费多及有创伤等缺点，很难全面推广使用。经阴道三维超声可以对患者病变宫腔的病理变化进行检测，由于该方法能够建立子宫内膜的三维数据库，故检测结果更加完善合理[3]。本文为了探讨在宫腔粘连患者的诊断过程中应用经阴道三维超声的诊断价值，选择了笔者所在医院相关的研究对象进行研究，取得了非常理想的成果，相关报道见下文。