超声对医源性子宫壁损伤的诊断价值

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1、超声对医源性子宫壁损伤的诊断价值［摘要］目的评价二维超声及彩色多普勒超声对医源性子宫壁损伤的诊断价值及临床意义。方法2006年1月〜2013年6月在本院或其他医院有过宫腔操作手术病史，临床和超声诊断子宫壁穿透性或非穿透性宫壁损伤的患者37例，对其声像特征进行总结分析。结果11例子宫壁穿透性损伤中有2例伴网膜嵌顿，9例无网膜嵌顿；26例非穿透性宫壁损伤,其中22例单纯非穿透性宫壁损伤患者宫壁有异常丰富的血流区，2例为黏膜下积液，2例为黏膜下血肿。结论子宫穿孔超声诊断准确率高，非穿透性子宫壁损伤临床症状轻，其血流丰富型的宫壁损伤声像图表现与滋养细胞肿瘤

2、和胚胎组织残留及宫腔内、输卵管间质部、子宫峡部瘢痕处妊娠光I才I型稽留流产相似，必须仔细检查，并结合病史、血3-HCG进行鉴别诊断，必要时定期随访、复查，从而减少误诊，避免再次行清宫术，减少患者的痛苦与恐慌。［关键词］二维超声；彩色多普勒超声；医源性损伤；子宫壁穿透性损伤；了宫壁非穿透性损伤［中图分类号］R81［文献标识码］A［文章编号］1674-4721(2014)04(c)-0102-04UltrasoundinthediagnosisofiatrogenicinjuryofuterinewallDepartmentofFunction,Shi

3、paiPeople'sHospitalofDongguanCityinGuangdongProvince,Dongguan523330,China[Abstract]ObjectiveToevaluatethediagnosticvalueandclinicalsignificanceofB-ultrasoundandcolorDopplerultrasoundforiatrogenicinjuryofuterinewall.Methods37casesofpatientswithpenetratingornon—penetratinginjury

4、ofuterinewalldiagnosedbycliniceilandultrasound,whichhadsurgeryhistoryofuterinesurgeryfromJanuary2006toJune2013inourhospitaiorotherhospitals.Thepatients,ultrasoundimagingcharacteristicswereanalyzed.Results11casesofpenetratinguterinewallinjury,ofwhich2caseshadcomplicationofoment

5、umincarcerationwhileother9casesnot.26casesofnon-penetratinguterinewallinjury,ofwhich22patients'uterinewallhadabnormalbloodricharea,2caseshadsubmucosaleffusionand2caseshadsubmucosalhematoma.ConclusionUltrasoundhasahighaccuracyinthediagnosisofuterineperforation.Clinicalsymptomso

6、fpatientswithnon-penetratinguterinewallinjuryaremildanditssonographicfeatureofblood-richareainuterinewal1issimilarwiththoseinpatientswithtrophoblastictumor,embryonictissueresidueandmissedabortionoccurredintheuterinecavity,interstitialtubalorscarsofuterineisthmusin•Therefore,do

7、ctorsshouldexaminetheandbloodP-HCG.Regularfollow-upandreviewshouldbeconductedifnecessary,candecreasemisdiagnosis,avoidunnecessaryre-curettagesurgeryandreducethepatients'painandpanic.［Keywords］Two-dimensionalultrasound;ColorDopplerultrasound;Iatrogenicinjury;Penetratinginjuryof

8、uterinewall;Non-penetratinginjuryofuterinewall宫腔操作所致的医源性子宫壁损伤