剪切波弹性成像评估米非司酮的宫颈软化效果

目的应用剪切波弹性成像(SWE)评估米非司酮在无痛人流手术前对宫颈的软化效果。方法选取我院行无痛人流手术的孕妇87例,随机分为试验组43例和对照组44例。试验组术前1 d晚上8时服用米非司酮50 mg,对照组不服用药物。应用SWE于术前1 d(试验组用药前)及手术当天(术前)分别测量宫颈外口前唇及后唇的剪切波速度(SWV),比较试验组及对照组两次所测SWV的差异;分析手术当天所测宫颈SWV与术中宫颈扩张程度评价的关系。结果试验组术前1 d测得的宫颈外口前唇及后唇SWV与手术当天测值比较,差异均有统计学意义(均P<0.05);对照组术前1 d测得的宫颈外口前唇及后唇SWV与手术当天测值比较,差异均无统计学意义。相关性分析结果显示,手术当天所测的宫颈外口前唇SWV与术中宫颈扩张程度评价呈正相关(r=0.458,P<0.05),宫颈外口后唇SWV与术中宫颈扩张程度评价无明显相关性。结论应用SWE可较好地评估米非司酮对宫颈的软化效果,宫颈外口前唇SWV有望作为客观评估宫颈软硬度的指标之一。

Evaluation of the cervical softening effect of mifepristone by shear wave elastography

Objective To explore the cervical softening effect of mifepristone by shear wave elastography(SWE)before painless abortion surgery.Methods A total of 87 pregnant women who underwent painless abortion surgery in our hospital were selected,and randomly divided into a test group of 43 cases and a control group of 44 cases.The test group took 50 mg of mifepristone at 8 pm the day before surgery,while the control group took no medication.The SWE technique was used to measure the shear wave veloaty(SWV)of the external os anterior and posterior at the day before the surgery(before the medication of the test group)and on the day of the surgery.The differences of SWV measured 2 times in the test group and the control group were compared.The relationship between the cervical SWV measured on the day of surgery and the intraoperative cervical dilation evaluation was analyzed.Results The SWV of the external os anterior and posterior measured one day before the surgery in the test group were statistically different from those measured on the day of the surgery(both P<0.05).There were no statistic difference between the SWV of the external os anterior and posterior measured one day before the surgery and the value measured on the day of the surgery in the control group.The results of correlation analysis showed that the SWV of the external os anterior on the day of surgery was positively correlated with the intraoperative cervical dilation evaluation(r=0.458,P<0.05).There was no significant correlation between the SWV of the external os posterior and the intraoperative cervical dilation evaluation.Conclusion SWE can be used to detect the cervical softening effect caused by mifepristone.SWV of the external os anterior is expected to be one of the indicators for objectively evaluating cervical softness.