经阴道三维能量多普勒超声对早期宫内妊娠黄体的临床研究

目的：探究经阴道三维能量多普勒超声对早期宫内妊娠黄体的检测在判断早孕预后中的应用价值。方法选取2015年1~12月在深圳宝安区妇幼保健院产科门诊进行孕检的早期宫内妊娠妇女192例作为研究对象，根据随访12周妊娠进展状况将孕妇分为正常早孕组86例，先兆流产组60例，难免流产组46例，运用经阴道三维能量多普勒扫描三组孕妇的妊娠黄体，通过虚拟器官计算机辅助分析(VOCAL)技术计算出血管形成指数(VI)、黄体血流指数(FI)、血管形成-血流指数(VFI)，并得出相应的参考值。结果正常早孕组VI、FI、VFI分别为(23.6±2.51)、(44.2±2.99)、(10.4±1.30)，先兆流产组分别为(17.3±2.16)、(38.4±2.64)、(6.64±0.89)，难免流产组分别为(13.5±1.97)、(32.7±2.45)、(4.40±0.64)，在各项血流指数的比较中难免流产组和先兆流产组的指标均明显低于正常早孕组，差异均具有统计意义(P<0.05)，难免流产组的指标明显低于先兆流产，差异具有统计意义(P<0.05)；同时先兆流产组的VI、FI、VFI诊断临界点分别为20.463、40.867、8.164，灵敏度和特异度分别为0.946、0.854；0.839、0.854；0.964、1。难免流产组的VI、FI、VFI诊断临界点分别为16.303、36.255、5.388，灵敏度和特异度分别为1.0、0.589；0.952、0.750；0.976、0.893。结论在早期宫内妊娠黄体的临床检查中采用经阴道彩色多普勒能量超声能够有效准确判断正常早孕、难免妊娠和先兆流产，对于早孕预后有重要的指导价值，值得临床上推广应用。

Clinical analysis of transvaginal three-dimensional power Doppler ultrasound on early intrauterine pregnancy of corpus luteum

Objective To explore the application of transvaginal three-dimensional power Doppler ultrasound in pregnancy corpus luteum to estimate the final result of in the early intrauterine. Methods A total of 192 cases of ear-ly pregnant women, who underwent maternity pregnancy test in Shenzhen Bao'an Maternal and Child Health Hospital be-tween January 2015 and December 2015, were selected as the research objects. According to the follow-up of 12 weeks of pregnancy status, these pregnant women were divided into the normal pregnancy group (n=86), threatened abortion group (n=60), inevitable abortion group (n=46). The corpus luteum of pregnant women was scanned by transvaginal three-dimensional power Doppler. The pregnant women's corpus luteum blood vessel formation index (VI), corpus lute-um blood flow index (FI), blood vessel formation-blood flow index (VFI) were measured through virtual organ comput-er-aided analysis (VOCAL), and the reference value of each group was calculated. Results VI, FI, VFI levels in inevita-ble abortion group [(13.5 ± 1.97), (32.7 ± 2.45), (4.40 ± 0.64), respectively] and threatened abortion group [(17.3 ± 2.16), (38.4 ± 2.64), (6.64 ± 0.89), respectively] were significantly lower than those in normal pregnancy group [(23.6 ± 2.51), (44.2 ± 2.99), (10.4 ± 1.30), respectively] (P<0.05), and the levels were also significantly lower in inevitable abortion group than threatened abortion group (P<0.05). The cut-off points of VI, FI, VFI in threatened abortion group were 20.463, 40.867, 8.164 respectively, with the corresponding sensitivity and specificity for 0.946, 0.854; 0.839, 0.854;0.964, 1. The cut-off points of VI, FI, VFI in inevitable abortion group were 16.303, 36.255, 5.388 respectively, with the corresponding sensitivity and specificity for 1.0, 0.589;0.952, 0.750;0.976, 0.893. Conclusion In clinical examination of early intrauterine pregnancy corpus luteum, transvaginal color Doppler ultrasound can effectively and accurately deter-mine the normal early pregnancy, threatened abortion and inevitable pregnancy, which has important guiding value for the prognosis of early pregnancy, and is worthy of popularization and application in clinic.