摘要
目的:探讨子宫腔超声指标预测早期稽留流产药物治疗效果的价值。方法:收集自2018年1月-2023年12月本院早期稽留流产患者药物治疗后24h子宫内膜厚度、宫腔不均质回声团大小、宫腔内多普勒血流等子宫腔超声指标,根据治疗结局分为完全流产组和不完全流产组,分析预测药物治疗不全的超声指标。结果:药物治疗完全流产组和不完全流产组的体重指数、既往妊娠丢失病史、人工流产次数、子宫内膜厚度,宫腔不均质回声团的平均直径的差异有统计学意义(t=-4.880,χ^(2)=22.587,χ^(2)=21.018,t=-5.081,t=-4.890;P<0.001),两组的子宫多普勒血流情况的差异也有统计学意义(χ^(2)=8.501,P<0.05)。多因素logistic回归分析显示,子宫内膜厚度是药物流产不全的独立危险因素(OR=1.194,95%CI 1.116~1.278)。超声子宫内膜厚度预测药物流不全的最佳临界值为19.1mm,敏感度为60.5%,特异度为95.0%。结论:药物治疗后24h内经阴道超声子宫内膜厚度与药物流产不全有关,可作为早期稽留流产药物治疗效果的参考指标。
Objective:To investigate the predictive value of the uterine cavity ultrasound indexes for the complete abortion of patients with miscarriage treated by the medical abortion during the first trimester of pregnancy.Methods:The data of the uterine cavity ultrasound indexes,such as the endometrial thickness,the diameter of heterogeneity echo mass in uterine cavity and the intrauterine Doppler blood flow,of the patients with miscarriage treated by medical abortion in 24 hours after treatment from January 2018 to December 2023 were collected.These patients with miscarriage treated by medical abortion were divided into group A(patients with complete abortion)and group B(patients with incomplete abortion)according to the treatment outcomes.Multivariate logistic regression analysis was used to analyze the ultrasound indicators of the incomplete abortion of the patients with miscarriage treated by medical abortion.Results:There were significant differences in THE body mass index value,the previous pregnancy loss history,the number of abortion,the endometrial thickness,and the average diameter of the heterogeneity echo mass of the patients between the two groups(t=4.880,χ^(2)=22.587,χ^(2)=21.018,t=5.081,t=4.890,and P<0.001),and there was also significant difference in the uterine blood flow by Doppler of the patients between the two groups(χ^(2)=8.501,P<0.05).Multivariate logistic regression analysis showed that the endometrial thickness of the patients was an independent risk factor for their incomplete medical abortion(OR=1.194,95%CI 1.116-1.278).The optimal threshold,the sensitivity and the specificity of the endometrial thickness by ultrasonic examination of the patients for predicting their incomplete medical abortion were 19.1 mm,60.5%and 95%,respectively.Conclusion:This study finds that the endometrial thickness by the uterine cavity ultrasound of the patients with miscarriage in 24h after the medical abortion is related with to their incomplete abortion,and which can be used as one of the valuable reference predictor of the success of the medical abortion for the miscarriage of the patients during the first trimester of pregnancy.
作者
王小菊
崔鑫
李天杰
林青
WANG Xiaoju;CUI Xin;LI Tianjie;LIN Qing(Beijing Friendship Hospital Affiliated to Capital Medical University,100050)
出处
《中国计划生育学杂志》
2024年第9期2113-2116,2121,共5页
Chinese Journal of Family Planning
基金
国家自然基金(82201825)。
关键词
早期妊娠
稽留流产
药物流产
不全流产
The first trimester of pregnancy
Miscarriage
Medical abortion
Incomplete abortion
