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目的探讨彩色多普勒超声预测子宫动静脉瘘患者行介入治疗的可行性。方法回顾性分析2011年1月至2014年12月我院收治的23例彩色多普勒超声诊断的子宫动静脉瘘患者的临床资料,比较介入治疗组与保守治疗组的彩色多普勒测量参数(收缩期峰值血流速度PSV,阻力指数RI)。结果 23例异常阴道出血者彩色多普勒超声均观察到子宫肌层及内膜下五彩镶嵌状血流信号。频谱为高速低阻型,平均PSV为59.8 cm/s,RI为0.42。7例(7/23)行盆腔动脉造影术并行选择性子宫动脉栓塞术治愈,PSV均值为85.6cm/s,RI为0.34,4例证实为子宫动静脉瘘,3例阴性;13例(13/23)行抗感染保守治疗治愈,其中2例动脉造影检查,2例均阴性,平均PSV 50.8cm/s,RI 0.43;3例(3/23)行宫纱填塞术治愈,平均PSV 51.7 cm/s,RI 0.49。比较介入治疗组与保守治疗组的PSV均值,差异有统计学意义(P<0.05)。结论彩色多普勒超声PSV值对于超声诊断的子宫动静脉瘘患者的治疗方案选择具有临床应用价值;PSV值有望成为鉴别高危子宫动静脉瘘患者行介入性治疗的重要参考指标。
Objective To investigate the feasibility of color Doppler ultrasound in predicting interventional treatment of uterine arteriovenous fistula. Methods The clinical data of 23 patients with uterine arteriovenous fistula diagnosed by color Doppler ultrasound in our hospital from January 2011 to December 2014 were analyzed retrospectively. The parameters of color Doppler measurement in interventional and conservative treatment groups were compared (Systolic peak flow velocity PSV, resistance index RI). Results In 23 cases of abnormal vaginal bleeding color Doppler ultrasound were observed in the myometrium and submucous multicolored mosaic blood flow signal. The spectrum was high-speed, low-impedance type with an average PSV of 59.8 cm / s and an RI of 0.42.7 (7/23) with pelvic arteriography undergoing selective uterine arterial embolization with an average PSV of 85.6 cm / s and RI 4 cases proved to be uterine arteriovenous fistula, 3 cases were negative; 13 cases (13/23) were cured by anti-infective conservative treatment, including 2 cases of arterial angiography, 2 cases were negative, mean PSV 50.8cm / s, RI 0.43 ; 3 cases (3/23) uterine incision cure, mean PSV 51.7 cm / s, RI 0.49. Compared PSV mean between interventional therapy group and conservative treatment group, the difference was statistically significant (P <0.05). Conclusions PSV value of color Doppler ultrasound is of clinical value for the treatment of uterine arteriovenous fistula in patients with ultrasound diagnosis. PSV value is expected to become an important reference index for the interventional treatment of high-risk uterine arteriovenous fistula.