采用经阴道超声评价不孕患者子宫内膜及动脉血流的临床研究

摘要

目的:分析采用经阴道超声检查子宫内膜及动脉血流参数在不孕育龄女性临床断和治疗中的价值,为不孕育龄女性的诊断和治疗疗效观察提供参考.方法:选择2014年6月至2016年6月江汉油田总医院收治的60倒不孕症女性为研究对象,设为观察组;选取同期在江汉油田总医院行产前健康体检的育龄女性60例作为对照组;两组患者均于分泌期行超声检查,检查过程中按照预定方案检查受检者的子宫内膜厚度、形态和子宫动脉血流情况[包括子宫动脉收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、子宫动脉阻力指数(RI)、搏动指数(PI)、和S/D值].比较两组受检者的子宫内膜厚度及子宫动脉血流指标的差异.观察组患者实施个体化治疗方案1、3、6个月后分别行阴道超声检查,比较患者治疗前、治疗后不同时间段子宫内膜厚度动脉血流指标的变化.结果:观察组扣对照组受检者的子宫内膜厚度比较差异无统计学意义(P＞0.05),观察组PSV、EDV明显低于对照组(P＜0.05),RI、PI、S/D明显高于对照组(P＜0.05).观察组患者治疗1、3、6个月PSV、EDV、S/D值较治疗前有明显提高(P＜0.05),RI、PI较治疗前明显降低(P＜0.05).而子宫内膜厚度均无明显变化.结论:子宫动脉血流状况差和不孕症关系密切,阴道超声检查结果反映了不孕症患者的子宫动脉血流情况,在不孕症程度判断和治疗疗效观察方面具有较高的临床价值.%Objective:To evaluate the application value of transvaginal ultrasonography in the diagnosis and treatment of infertile women through the detecting theendometrial and blood flow parameters,in order to provide reference for the diagnosis and treatment of infertility.Methods:60 infertile female in our hospitalfrom June 2014 to June2016 were selectedas the observation group.Another 60 healthy women in our hospital for prenatal health examinationduring the same period were chosen as the control group.Patients in both groups were examined by ultrasound in secretory phase,to detect the endometrial thickness,morphology and uterine artery blood flow [including uterine artery peak systolic velocity (PSV),end diastolic velocity (EDV),uterine artery resistance index (RI) and pulsatility index(PI),S/D] according to a predetermined plan.Differences in endometrial thickness and uterine artery blood flow between the two groups were compared.Patients in the observation group were treated with individualized treatment for 1,3,and 6 months respectively,and the changes in arterial blood flow index were compared between before and after treatment.Results:There was no significant difference in endometrial thickness betweenthe observation group and the control group(P ＞ 0.05).The PSV,EDV in the observation group was significantly lower than that of the control group(P ＜0.05),while RI,PI and S/D were significantly higher than those of control group(P ＜ 0.05).In the observation group,the PSV,EDV and S/D values of were significantly higher than those before treatment(P ＜ 0.05),and RI and PI were significantly lower than those before treatment(P ＜ 0.05) but there was no significant change in endometrial thickness.Conclusions:Poor uterine artery blood flowis closely related toinfertility.Since transvaginal ultrasound reveals the uterine artery blood flow of patients with infertility,it is of high clinical value in the diagnosis and treatment of infertility.