摘要
目的探讨经阴道超声(transvaginal ultrasound,TVS)在不伴有不典型子宫内膜增生诊治随访中的价值。方法选择成都医学院第一附属医院2017年9月至2018年12月首次经内膜组织学检查确诊为不伴有不典型子宫内膜增生患者66例,予孕激素治疗,采用TVS联合组织学检查随访。根据组织学是否缓解分为有效组和无效组,分析治疗前后子宫内膜TVS各项指标及异常子宫出血(abnormal uterine bleeding,AUB)变化。结果有效组治疗后子宫内膜厚度测值降低,子宫内膜回声均匀比例增高,宫腔线显示清晰比例增高,AUB缓解(P<0.05);无效组治疗前后子宫内膜厚度、回声、宫腔线显示,AUB变化,差异均无统计学意义(P>0.05);两组治疗前后CDFI显示无明显变化;治疗后有效组与无效组比较,内膜厚度测值明显降低,回声趋于均匀,差异均有统计学意义(P<0.05)。66例患者中51例患者存在AUB,有效组治疗后AUB明显缓解,AUB缓解率明显高于无效组(P<0.05)。结论在子宫内膜增生的诊治随访中,应重视AUB的转归;通过TVS检测子宫内膜厚度、回声、宫腔线显示情况综合评估治疗效果,具有较好的参考意义。
Objective To explore the value of transvaginal ultrasound(TVS)in the diagnosis and treatment and follow-up of endometrial hyperplasia without atypia.Methods 66 patients diagnosed with hyperplasia without atypia by endometrial histological examination for the first time in The First Affiliated Hospital of Chengdu Medical College from September 2017 to December 2018 were selected,progesterone was given to therapy,followed up with TVS combined with histopathological examination.According to the histological examination,the patients were divided into the effective group and the ineffective group,analyzed the changes of TVS endometrial indicators and abnormal uterine bleeding(AUB).Results In the effective group,the measured value of endometrial thickness decreased,the proportion of uniform endometrial echo increased,the proportion of clear display of uterine cavity line increased,and the AUB relieved after treatment(P<0.05);there was no significant difference in the changes of endometrial thickness,echo,uterine cavity line and AUB in the ineffective group before and after treatment(P>0.05).The CDFI of the two groups before and after treatment showed no significant change.After treatment,compared with the ineffective group,the measured value of endometrial thickness in the effective group was significantly reduced,the echo tended to be uniform,and the difference was statistically significant(P<0.05).51 out of 66 patients had AUB.The AUB of the effective group was significantly relieved after treatment,and the AUB remission rate was significantly higher than that of the ineffective group(P<0.05).Conclusion During the diagnosis,treatment and follow-up of endometrial hyperplasia,attention should be paid to AUB.Using TVS to detect endometrial thickness,echo,and uterine cavity line display to comprehensively evaluate the treatment effect,which has a good reference significance.
作者
谢加琼
邓洁
李婵玉
徐蕾
Xie Jiaqiong;Deng Jie;Li Chanyu;Xu Lei(Department of Gynecology,The First Affiliated Hospital of Chengdu Medical College,Chengdu Sichuan 610500,P.R.China)
出处
《中国计划生育和妇产科》
2021年第12期74-77,共4页
Chinese Journal of Family Planning & Gynecotokology
基金
四川省医学青年创新科研课题计划(项目编号:Q19066)。
关键词
不伴有不典型子宫内膜增生
孕激素
经阴道超声
组织病理学
endometrial hyperplasia without atypia
progesterone
transvaginal ultrasound
histopathological examination
