不同残留物类型药物流产不全的经阴道超声特征研究

丁延华; 李迎华; 赵丽燕; 姚继芹

doi:10.16766/j.cnki.issn.1674-4152.003929

不同残留物类型药物流产不全的经阴道超声特征研究

doi: 10.16766/j.cnki.issn.1674-4152.003929

1.
杭州市妇产科医院超声心电科，浙江杭州 310008
2.
杭州市妇产科医院妇科

基金项目:

浙江省医药卫生科技计划项目 2025KY1178

详细信息

通讯作者:
丁延华，E-mail: dyh52066@126.com

中图分类号: R445.1 R714.21
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- 文章访问数: 4
- HTML全文浏览量: 2
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-12-07
- 网络出版日期: 2025-05-14

Study on transvaginal ultrasound characteristics of incomplete abortion caused by different types of residual drugs

1.
Department of Ultrasound and Electrocardiogram, Hangzhou Obstetrics and Gynecology Hospital, Hangzhou, Zhejiang 310008, China

摘要

摘要: 目的探讨药物流产不全患者不同残留物类型的经阴道超声特征差异，以评估其用于指导药物流产不全治疗方案制定的临床价值。方法选取2022年1月—2024年6月于杭州市妇产科医院就诊并接受治疗的150例药物流产不全患者为研究对象，根据病理检查结果，以残留物类型不同分为绒毛膜蜕膜组(109例)和非绒毛膜蜕膜组(41例)，对全部研究对象进行经阴道超声检查，观察不同类型药物流产不全残留物在形态、回声信号、血流分布及血流动力学等超声特征方面的差异情况。结果绒毛膜蜕膜组出现子宫体积增大患者比例显著高于非绒毛膜蜕膜组(P<0.05)，且绒毛膜蜕膜残留物以团块形为主，而非绒毛膜蜕膜残留物则以片形为主。绒毛膜蜕膜残留物超声信号以低回声和混合回声为主，而非绒毛膜蜕膜残留物超声信号以强回声为主(P<0.001)。绒毛膜蜕膜组患者残留物血流丰富比例(89.91%，98/109)显著高于非绒毛膜蜕膜组(9.76%, 4/41), 差异有统计学意义(χ²=87.961，P<0.001)。绒毛膜蜕膜组患者药物流产后残留物血流搏动指数(PI)和阻力指数(RI)分别为0.86±0.13、0.61±0.09，均显著低于非绒毛膜蜕膜组(1.47±0.21、0.74±0.11，P<0.001)。结论不同类型药物流产不全残留物在形态、回声信号、血流分布及血流动力学等超声特征方面均存在差异，经阴道超声检查在指导药物流产不全治疗方式选择方面具有较高应用价值。
- 药物流产 /
- 残留物 /
- 经阴道超声 /
- 血流动力学 /
- 诊断 /
- 治疗
Abstract: Objective To investigate the differences in transvaginal ultrasound characteristics among different types of residues in patients with incomplete medical abortion, and to evaluate their clinical value in guiding the development of individualized treatment strategies. Methods A total of 150 patients with incomplete medical abortion who received treatment at Hangzhou Obstetrics and Gynecology Hospital from January 2022 to June 2024 were selected as the research subjects. Based on pathological examination results, the residual materials were divided into two groups: the chorionic decidua group (109 cases) and the non-chorionic decidua group (41 cases). Transvaginal ultrasound examination was performed on all study subjects to assess the differences in ultrasound characteristics, including morphology, echo signal, blood flow distribution, and hemodynamics between the two groups. Results The proportion of patients with increased uterine volume in the chorionic and decidua group was significantly higher than that in the non-chorionic decidua group (P<0.05). The residual of chorionic decidua group mainly presented as the form of lumps, while the residual of non-chorionic decidua mainly appeared as the form of patches. The ultrasound signals of residual chorionic decidual tissue were mainly hypoechoic and mixed echogenic, while the ultrasound signals of non-residual chorionic-decidual tissue were mainly hyperechoic signals (P<0.001). The proportion of residual blood flow signals in the chorionic decidua group (89.91%, 98/109) was significantly higher than that in the non-chorionic decidua group (9.76%, 4/41), with a statistically significant difference (χ²=87.961, P<0.001). The pulsatility index (PI) and resistance index (RI) of residual blood flow after medical abortion in the chorionic decidua group were 0.86±0.13 and 0.61±0.09, respectively, which were significantly lower than those in the non-chorionic decidua group (1.47±0.21 and 0.74±0.11, P<0.001). Conclusion Significant differences were observed in ultrasound characteristics, including morphology, echo signal, blood flow distribution, and hemodynamics, among different types of residues in incomplete medical abortion. Transvaginal ultrasound demonstrates high clinical value in guiding the selection of treatment methods for incomplete medical abortion.
- Medical abortion /
- Residue /
- Transvaginal ultrasound /
- Hemodynamics /
- Diagnosis /
- Treatment

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表 1 2组药物流产不全患者一般资料比较(x±s)

Table 1. Comparison of general Information between two groups of patients with incomplete medical abortion (x±s)

组别	例数	年龄(岁)	BMI	停经时间(d)
绒毛膜蜕膜组	109	31.41±4.25	23.15±1.94	39.25±4.13
非绒毛膜蜕膜组	41	31.75±4.39	22.96±1.83	39.67±4.52
t值		0.416	0.542	0.541
P值		0.628	0.588	0.589

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表 2 2组药物流产不全患者子宫及残留物超声形态比较[例(%)]

Table 2. Comparison of uterine and residual ultrasound morphology between two groups of patients with incomplete medical abortion [cases (%)]

组别	例数	子宫体积		药物流产后残留物形态
组别	例数	正常	体积增大	片形	团块形
绒毛膜蜕膜组	109	75(68.81)	34(31.19)	21(19.27)	88(80.73)
非绒毛膜蜕膜组	41	38(92.68)	3(7.32)	36(87.80)	5(12.20)
χ²值		9.140		59.404
P值		0.003		<0.001

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表 3 2组药物流产不全患者残留物超声信号特征比较[例(%)]

Table 3. Comparison of ultrasonic signal characteristics of drug abortion residue between two groups of patients with incomplete medical abortion [cases (%)]

组别	例数	强回声	低回声	混合回声
绒毛膜蜕膜组	109	18(16.51)	32(29.36)	59(54.13)
非绒毛膜蜕膜组	41	31(75.61)	4(9.76)	6(14.63)
χ²值			54.118
P值			<0.001

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表 4 2组药物流产不全患者残留物血流分布状况比较[例(%)]

Table 4. Comparison of blood flow distribution of drug abortion residues between two groups of patients with incomplete medical abortion [cases (%)]

组别	例数	0级	Ⅰ级	Ⅱ级	Ⅲ级	残留物血流丰富
绒毛膜蜕膜组	109	2(1.83)	9(8.26)	41(37.61)	57(52.29)	98(89.91)
非绒毛膜蜕膜组	41	16(39.02)	21(51.22)	3(7.32)	1(2.44)	4(9.76)
注：2组患者残留物血流丰富比例比较，χ²=87.961，P<0.001。

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表 5 2组药物流产不全患者残留物血流动力学超声指标比较(x±s)

Table 5. Comparison of hemodynamic ultrasound indicators of drug abortion residue between two groups of patients with incomplete medical abortion (x±s)

组别	例数	PI	RI
绒毛膜蜕膜组	109	0.86±0.13	0.61±0.09
非绒毛膜蜕膜组	41	1.47±0.21	0.74±0.11
t值		21.381	7.405
P值		<0.001	<0.001

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