药流后阴道持续出血的声像学分析及临床评价

目的:探讨一种超声学参照体系以评价药物流产的临床效果。方法:对100例早孕妇女药物流产后采用B型超声波检查,前瞻性动态观察宫腔声像学变化,分析和总结药流后不同结局(完全流产vs.不全流产)的声像学规律。结果:100例对象中完全流产92例(92%),不全流产8例(8%),无1例继续妊娠。胚囊排出后依B超下宫内残留组织的形态及回声将声像图分为3型:A、B和C型。第10天有残留组织声像图存在对出血持续时间无显著性影响(P>0.05);若第15天仍有残留组织征象存在时,将对出血持续时间有显著性影响(P<0.01)。第15天完全流产者和不全流产者子宫内膜平均厚度分别为(9.5±5.0)mm和(15.7±3.1)mm,统计学上有极显著性意义(P<0.0001)。结论:B超作为1种无创伤性方法,其对药物流产的动态监测而获得的声像学规律对临床工作有着重要的指导意义。

Sonographic analysis and clinical evaluation on consecutive bleeding after medical abortion

Objective:To explore a novel contrast system on evaluating the outcome of medical abortion.Methods:A total of 100 women consented to medical abortion. By prospectively observing the dynamic sonographic changes of uterus, the sonographic rules of different outcomes (complete abortion vs incomplete abortion) were analyzed and summarized after medical abortion.Results:Of 100 subjects, 92 underwent complete abortion (92%) and 8 incomplete abortion (8%). No ongoing pregnancy occurred. After expulsion of gestational sac, it was identified into three types of sonography on the basis of morphology and rebounding-echo of residue tissues in uterus: Type A, B and C. There was no significant difference between the prolonged vaginal bleeding and existed sonographic indication of the retained tissues on day 10 (P>0.05). However, there was significant difference on day 15(P<0.01). The mean endometrial thickness between complete and incomplete abortion was 9.5±5.0mm and 15.7+3.1mm respectively(P <0.000 1) .Conclusion:Since B ultrasound is a non-traumatic means, the sonographic laws aquired from monitoring the dynamic findings of intrauterus play a pivotal role in clinical settings of medical abortion.