摘要
目的探讨超声监测卵泡发育对自然流产患者的病因学诊断及指导治疗的意义。方法对164例有自然流产史的患者行超声监测卵泡发育情况,并对其中的110例进行黄体期孕酮测定或子宫内膜活检。有122例患者接受了81个周期的促排卵或黄体支持治疗,在治疗周期中同样行超声监测排卵,并分析其妊娠结局。140例年龄相仿的不孕症女性患者用作对照组。结果自然流产患者中小卵泡排卵的发生率为73.2%(120/164),高于对照组的37.1%(52/140),差异有显著性(P<0.01)。卵泡排卵的患者中黄体功能不全的发生率为50.0%(40/80)。治疗周期HCG注射日卵泡径线大于等于18mm时妊娠率为39.6%(38/96),活产率为33.3%(32/96),再次自然流产的发生率为15.8%(6/38),而卵泡径线小于18mm时的妊娠率为15.2%(10/66),活产率为3.0%(2/66),再次自然流产的发生率为80.0%(8/10),差异均有显著性(P<0.001)。结论小卵泡排卵是引起自然流产原因之一,超声监测卵泡发育是诊断小卵泡的唯一方法,治疗中采用超声监测卵泡生长情况可防止再次自然流产的发生。
Objective To study the etiologic diagnosis and treatment meamings of follicular development detected with B-uhrasound among spontaneous abortion patients. Methods The follicular development was detected by B-ultrasound in 164 patients with history of spontaneous abortions. Among them progestogen measurement and endometrial biopsy in luteal phase were performed in 110 patients. Eighty-one cycles of ovulation induction or luteal support were done in 122 cases; in these cycles,the follicular development was detected by ultrasound identically and the pregnancy outcomes were analyzed. A hundred and forty age-matched female patients with infertility were taken as control group. Results The incidence of small follicular ovulation was 73.2%( 120/164)in spontaneous abortion patients, which was higher than that in the control group 37.1%(52/140). The incidence of lutea phase defect with small follicular ovulation was 50.0%(40/80). The pregnancy rate was 39.6%(38/96) and live birth rate was 33.3%(32/96). When the follicular diameter reached 18 ram,on the day of HCG injection in ovulation induced cycles of natural cycle, higher than that in the group of follicular diameter was less than 18 mm,15.2 % (10/66) and 3.0%(2/66) respectively (P =0.018, P =0.001). When the follicular diameter were less than 18 ram,the incidence of spontaneous abortion rate would be 80% (8/10), which was higher than that in the guoup of follicular diameter reached to 18 mm. Conclusions Small follicular ovulation is one of the reasons causing spontaneous abortion. Follicular development detection with ultrasound is the only way to diagnose the small follicular ovulation. During treatment, follicular development detection with ultrasound can help to decrease the incidence of second spontaneous abortion.
出处
《实用医学影像杂志》
2009年第4期255-257,共3页
Journal of Practical Medical Imaging
关键词
自然流产
卵泡发育
超声检查
Spontaneous abortion
Follicular development
B-ultrasound