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目的探讨经腹及经阴道彩色多普勒超声(TVS-CD)在药物流产前、后的监测及对清宫的临床指导价值。方法对186例患者(孕周≤7周)在药流前和后1、3、5d分别行经腹、阴道彩色多普勒超声检查,记录孕囊直径、Vmax、Vmin、P/I、RI、S/D等参数,并与病理、随访情况对照。结果药流成功者148例,成功率79.6%;38例中有33例宫腔残留物内显示局灶性血流丰富区,31例呈低阻力动脉血流频谱,RI(0.52±0.05),清宫病理均阳性;2例呈持续性静脉血流频谱;4例未测到血流信号者中,仅1例病理阳性。服药后子宫动脉和滋养层动脉的RI、收缩期与舒张期比值均增高,Vmax和PBF明显减低,差异有统计学意义(P<0.05)。结论应用TVS-CD监测药流前后孕囊周边血流变化,有助于临床医生及早采取措施对药流失败者予以补救治疗。
Objective To investigate the value of transabdominal and transvaginal color Doppler ultrasonography (TVS-CD) before and after medical abortion and its clinical value in Qing palace. Methods 186 cases (gestational week ≤7 weeks) underwent abdominal and vaginal color Doppler echocardiography before and after 1, 3 and 5 days of medical abortion respectively. The gestational sac diameter, Vmax, Vmin, P / I, RI, S / D and other parameters, and pathological, follow-up control. Results The success rate of drug abortion in 148 cases, the success rate of 79.6%; 38 cases of intrauterine residue in 33 cases showed focal blood flow-rich area, 31 cases showed low resistance arterial blood flow spectrum, RI (0.52 ± 0.05) Pathology were positive; 2 cases were continuous venous flow spectrum; 4 cases were not detected in the blood flow signal, only 1 case pathologically positive. RI, systolic and diastolic ratios of uterine artery and trophoblast arteries increased after treatment, while Vmax and PBF decreased significantly (P <0.05). Conclusion TVS-CD monitoring of blood flow around the gestational sac before and after pregnancy can help clinicians to take early measures to remedy the failure of losers.