目的:应用阴道彩色多普勒超声检测健康育龄妇女在放置宫内节育器(IUD)前后子宫动脉及螺旋动脉的血流动力学参数,探讨其变化规律.方法:随机选取自愿在我院放置IUD的180例健康生育期已婚妇女.将有异常子宫出血的40例妇女作为观察组,从140例无异常子宫出血的妇女中随机选取40例作为对照组,在卵泡发育期应用经阴道彩色多普勒超声成像技术对放置IUD前后子宫动脉及螺旋动脉搏动指数(PI)、阻力指数(RI)和收缩舒张比值(S/D)进行检测,并对结果进行比较.结果:对照组在放置IUD后的PI、RI和S/D值分别为(1.49±0.26)、(0.68±0.06)、(3.00±0.72),观察组在放置IUD后的PI、RI和S/D值分别为(1.31±0.22)、(0.66±0.08)、(2.70±0.69),观察组放置IUD后的PI、RI和S/D值均明显低于对照组,差异均有统计学意义(均P<0.05).观察组在放置IUD前后,子宫动脉和子宫螺旋动脉的RI和S/D值没有明显变化(P>0.05),但PI值在放置IUD前后[(2.11±0.33)vs(1.43±0.30)]比较,差异有统计学意义(P<0.05).结论:放置IUD后子宫动脉及螺旋动脉PI、RI值降低可表示子宫异常出血的风险增加,在放置IUD后检测子宫动脉及螺旋动脉PI、RI值,有助于预测子宫异常出血的情况.%Objective: To explore the change rule of the uterine artery and spiral arterial hemodynamic parameters by applying transvaginal color doppler ultrasound on health women in reproductive age before-and-after placing intrauterine device (IUD). Methods: 180 cases of healthy married women in reproductive age voluntarily placing IUD in our hospital were randomly selected. 40 cases with abnormal uterine bleeding were selected as the observation group, 40 cases randomly selected from 140 cases without abnormal uterine bleeding were selected as the control group, in the period of follicular development, transvaginal color doppler ultrasound imaging technology was applied to detect spiral pulses index (PI), resistance index (RI) and contraction diastolic ratio (S/D) before-and-after placing IUD, and the results were compared. Results: RI, PI and S/D value in the observation group after placing IUD were (1.31 ±0.22), (0.66±0.08), (2.70±0.69) respectively, and they were higher than those in the control group [(1.49±0.26), (0.68±0.06), (3.00±0.72)], there were significant differences between them (all P＜0.05). RI and S/D value of uterine artery and uterus spiral arterial before placing IUD in the observation group were not change significantly (P＞0.05), but there was a significant difference of PI value between before and after placing IUD [(2.11±0.33) vs (1.43±0.30)] (P＜0.05). Conclusion: The decreasing of PI, RI values in uterine artery and spiral artery placing after IUD may indicate the increasing risk of abnormal uterine bleeding. To detect PI, RI values of uterine artery and spiral artery placing after IUD will help to predict the uterine abnormal bleeding.
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