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目的寻找判断药物流产完全与否的早期、客观的超声影像学指标。方法2003年7~11月东南大学附属中大医院应用经阴道彩色多普勒超声技术,对服用米非司酮配伍米索前列醇终止早孕的妇女,作药物流产前后孕囊着床部位螺旋动脉血流信号和血流动力学参数的比较。第15天仍有不规则阴道出血者全部行清宫手术和病理检查,并与超声检查结果作对照。结果40例宫内早孕中,第15天经临床或病理证实属于完全流产者22例(55.0%),螺旋动脉呈高阻血流;不全流产者18例(45.0%),螺旋动脉呈低阻血流;超声诊断的灵敏度为94.4%,特异度为100.0%,误诊率为0,漏诊率为5.6%。结论孕囊排出当天即可通过着床部位的血供状态预测流产效果。RI可能是最敏感的指标,RI>0.6,预示完全流产;RI≤0.6,预示第15天有可能为不全流产。
Objective To find an early and objective ultrasound imaging index for judging whether abortion is complete or not. Methods From July to November 2003, the Affiliated Zhongda Hospital of Southeast University used transvaginal color Doppler ultrasonography to study the effect of mifepristone and misoprostol in termination of early pregnancy before and after medical abortion gestational sac placement spiral artery Comparison of blood flow signals and hemodynamic parameters. On the 15th day, there was still irregular vaginal bleeding in all patients underwent clear-line surgery and pathological examination, and compared with the results of ultrasound examination. Results Among the 40 cases of intrauterine pregnancy, 15 cases were diagnosed clinically or pathologically as complete abortion in 22 cases (55.0%), the spiral artery showed high impedance blood flow, 18 cases (45.0%) had incomplete abortion, and the spiral arteries showed low resistance Blood flow; the sensitivity of ultrasonic diagnosis was 94.4%, specificity was 100.0%, misdiagnosis rate was 0, the rate of misdiagnosis was 5.6%. Conclusion The gestational sac can be discharged from the site of the day to predict the effect of abortion. RI may be the most sensitive index, RI> 0.6, indicating complete abortion; RI ≤ 0.6, indicating that the first 15 days may be incomplete abortion.