不孕不育患者子宫内膜监测中阴道B超的应用研究
Study on the Application of Vaginal Ultrasound in Monitoring the Endometrium of Infertile Patients

DOI: 10.12677/NS.2021.103033, PP. 200-205

Keywords: 不孕不育，子宫内膜监测，阴道B超，宫腔镜检查，体外受精–胚胎移植
Infertility, Endometrial Monitoring, Vaginal Ultrasound, Hysteroscopy, In Vitro Fertilization-Embryo Transfer

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的：评价经阴道B型超声检查在不孕不育患者子宫内膜监测中的临床价值。方法：选取2019年3月至2020年2月间本院收治200名不孕不育患者，纳入患者在接受宫腔镜检查同时进行经阴道B型超声检查，以病理检查结果为诊断金标准，评价经阴道B型超声检查结果。结果：200例患者经阴道超声检查发现子宫内膜异常率82.00% (164/200)，异常回声类型包括混合性回声67例、回声不均匀32例、回声极不均匀18例、内膜线中断18例、局部强回声光团17例、内膜线不光滑6例、内膜中线回声增强6例；包括形态正常36例；经阴道超声检查提示子宫内膜混合性回声、回声不均匀、回声极不均匀、内膜线中断、局部强回声光团、内膜线不光滑、内膜中线回声增强的符合率均 > 90.0%。结论：经阴道B型超声检查在不孕不育患者子宫内膜监测中具有较高的诊断率，该检查方法便捷、无创，可作为拟接受IVF-ET患者在治疗前子宫内膜病变初步筛查的手段，针对IVF种植失败患者仍有必要接受宫腔镜检查诊断。
Objective: To evaluate the clinical value of transvaginal B-mode ultrasound in monitoring the endometrium of infertile patients. Methods: Select 200 infertility patients admitted to our hospital from March 2019 to February 2020. The patients were included in the hysteroscopy and transvaginal B-mode ultrasound examination. The pathological examination results were used as the diagnostic gold standard. Evaluate the results of transvaginal B-mode ultrasonography. Results: The abnormal rate of the endometrium in 200 patients was 82.00% (164/200). The abnormal echo types included 67 cases of mixed echo, 32 cases of uneven echo, 18 cases of extremely uneven echo, and interruption of endometrial line 18 cases, 17 cases of local hyperechoic light clusters, 6 cases of endometrial line not smooth, 6 cases of endometrial midline echo enhancement; including 36 cases of normal morphology; transvaginal ultrasound examination revealed mixed echo of the endometrium, uneven echo, the echo is extremely uneven, the inner membrane line is interrupted, the local strong echo light group, the inner membrane line is not smooth, and the coincidence rate of the inner membrane midline echo enhancement is > 90.0%. Conclusion: Transvaginal B-mode ultrasound has a high diagnostic rate in endometrial monitoring of infertility patients. This examination method is convenient and non-invasive, and can be used as a preliminary screening for endometrial lesions in patients who intend to receive IVF-ET before treatment. It is still necessary for patients with failed IVF implantation to undergo hysteroscopy diagnosis.

References

[1]	张雪. 经阴道超声卵泡监测在治疗不孕不育中的价值分析[J]. 影像研究与医学应用, 2020, 4(16): 106-107.
[2]	邓巧敏. 探究经阴道超声联合三维超声造影在妇科不孕不育疾病诊治当中的应用价值[J]. 影像研究与医学应用, 2020, 4(12): 43-45.
[3]	胡海平. 妇科阴道超声检查卵巢巧克力囊肿价值分析[J]. 影像研究与医学应用, 2020, 4(6): 197-198.
[4]	方红, 韦巧萍, 陈丽丽. 经阴道超声监测卵巢窦卵泡计数与血流动力学变化评估卵巢反应性及妊娠结局[J]. 中国高等医学教育, 2019(5): 138-139.
[5]	Oliveira, F.G., Abdelmassih, V.G., Diamond, M.P., et al. (2003) Uterine Cavity Findings and Hysteroscopic Interventions in Patients Undergoing in Vitro Fertilization-Embryo Transfer Who Repeatedly Cannot Conceive. Fertility and Sterility, 80, 1371-1375. https://doi.org/10.1016/j.fertnstert.2003.05.003
[6]	曾红艳, 武忆东, 邓淑娟. 经阴道超声卵泡监测在治疗不孕不育中的价值分析[J]. 中国医学创新, 2018, 15(16): 123-125.
[7]	李仁丽, 田雅菊, 王丹, 等. 经阴道超声与超声宫腔造影在子宫内膜息肉患者中的诊断价值[J]. 中国药物经济学, 2016, 11(9): 182-184.
[8]	Momeni, M., Rahbar, M.H. and Kovanci, E. (2011) A Meta-Analysis of the Relationship between Endometrial Thickness and Outcome of in Vitro Fertilization Cycles. Journal of Human Reproductive Science, 4, 130-137. https://doi.org/10.4103/0974-1208.92287
[9]	曹泽毅, 主编. 中华妇产科学[M]. 北京: 人民卫生出版社, 1999: 2181-2185.
[10]	蔡款, 梁伟翔, 王伟群, 等. 经阴道超声在不孕症患者宫腔疾病中的应用价值[J]. 临床医学工程, 2012, 19(8): 1234-1236.
[11]	田密苏, 郑晓红, 郑波, 等. 经阴道超声在宫外孕早期诊断中的应用价值[J]. 河北医药, 2012, 34(12): 1844-1845.
[12]	段美林. 经阴道超声在不孕不育中的诊断价值探讨[J]. 中国社区医师(医学专业), 2010, 12(6): 100.
[13]	Zhao, J., Zhang, Q. and Li, Y. (2012) The Effect of Endometrial Thickness and Pattern Measured by Ultrasonography on Pregnancy Outcomes during IVF-ET Cycles. Reproductive Biology and Endocrinology, 10, Article No. 100. https://doi.org/10.1186/1477-7827-10-100
[14]	何晓宇, 黄惠娟, 何春妮, 等. 宫腔镜诊治宫腔因素不孕不育的价值[J]. 中国微创外科杂志, 2003(3): 229-232.

Full-Text