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目的:探讨药物流产后子宫持续出血患者的超声图像特征、彩色血流表现及其临床诊断价值。方法:对临床80例口服米非司酮与米索前列醇片药物流产胚囊排出后10～20 d以上仍有子宫持续出血者进行经腹部+阴道子宫、附件超声检查。结果:药物流产胚囊排出后子宫持续出血患者的超声检查表现如下:①宫腔内有不规则的高回声或不均质的低回声团,形态不规则与正常肌层分界不清,部分病灶周边可探及短棒样、星点样血流信号;②经腹二维超声检查图像仅表现为内膜回声稍不均匀,呈不均质低回声斑,无明显宫腔内异常回声团,经阴道扫查不均质回声斑局部回声减低,与子宫肌层无明显界限;③子宫内膜粗糙,部分增厚,与肌壁分界清,部分伴宫腔内少量积液。结论:超声检查能根据声像图表现特征的不同为临床治疗提供有利的依据,以采取适当的治疗措施,终止子宫出血,对指导临床治疗具有重要的意义。
Objective: To investigate the characteristics of ultrasound images, color flow performance and clinical diagnostic value in patients with persistent uterine bleeding after medical abortion. Methods: 80 cases of oral administration of mifepristone and misoprostol tablets medical abortion embryos sac after 10 ~ 20 d or more persistent uterine bleeding were transabdominal + vaginal uterus, annex ultrasound. Results: The ultrasound examination of uterine bleeding after medical abortion embryo sac was discharged showed as follows: ① There are irregular hypoechoic or hypoechoic masses in the uterine cavity, the irregular shape and irregularity of the normal muscular layer and some lesions Peripheral probing and short rod-like, star-like blood flow signal; ② abdominal two-dimensional ultrasound images showed only slightly uneven endometrial echo was heterogeneous hypoechoic spots, no significant intrauterine abnormal echo group, Transvaginal scanning uneven echo echo local echo reduced, and no obvious boundaries with the myometrium; ③ endometrial rough, thickening, and the muscle wall demarcation clear, part of the uterine cavity with a small amount of effusion. Conclusion: Ultrasound examination can provide favorable basis for the clinical treatment according to the different characteristics of the sonographic image. It is of great significance to take appropriate treatment measures to terminate the uterine bleeding and guide the clinical treatment.