目的：应用经阴道三维超声评价子宫内膜整理术对体外受精-胚胎移植（IVF-ET）患者内膜容受性的影响，探讨内膜整理术对改善子宫内膜容受性，提高临床妊娠率的价值。方法：采集在我院IVF-ET反复失败3次以上且具有子宫内膜整理术的适应症患者103例，根据患者自愿原则，将其中施行子宫内膜整理手术的55例患者分为整理组，其余未做过子宫内膜整理术的48例患者分为未整理组。采用经阴道三维超声分别于HCG日、ET日检测两组患者子宫内膜厚度、容积、内膜及内膜下血流分布、血流参数（S?蛐D、PI、RI、VI、FI、VFI），于2周后超声检查两组患者宫内情况并追踪妊娠结局。结果：整理组与未整理组一般情况无统计学差异（P>0.05）；HCG日、ET日子宫内膜容积、厚度无差异（P>0.05），子宫内膜血流参数S?蛐D、PI、RI均低于未整理组（P＜0.05）；ET日整理组FI值高于未整理组（P＜0.05）。整理术前后ET日子宫内膜血流参数S?蛐D、RI、FI有统计学差异（P＜0.05）。内膜整理组的种植成功率和临床妊娠率高于未整理组。结论：子宫内膜整理术有助于改善子宫内膜及内膜下血流灌注，进而可以对提高胚胎种植率及临床妊娠成功率有帮助。
Abstract
Objective: To analyze the endometrial impact of endometrial finishing technique in IVF-ET patients, discuss to improve endometrial receptivity and the clinical significance of the clinical pregnancy rate using transvaginal three-dimensional ultrasound. Methods: One hundred and three patients treated with IVF-ET at our hospital were collected. All patients had failed more than three times and had the indication of endometrial finishing surgery. Patients were divided into organize group(55 patients were implemented endometrial finishing surgery) and unstructured group(48 patients did not have the surgery). Detected endometrial volume, thickness, type, endometrial and subendometrial blood flow parameters(RI, PI, S?蛐D, VI, FI, VFI) by ultrasound in ET day and HCG day and tracked pregnancy outcomes. Results: There was no difference in the general situation between the two groups(P>0.05), no difference in endometrial volume and thickness between the two groups in ET day and HCG day(P>0.05). Endometrial blood flow(PI, RI, S?蛐D) in organize group were lower than the unstructured group(P<0.05), FI in organize group was higher than the unstructured group in ET day(P<0.05), before and after the endometrial finishing surgery, endometrial blood flow(PI, RI, FI) were different(P<0.05), the pregnancy rate in organize group was higher than the unstructured group. Conclusion: Endometrial finishing technique can improve endometrial blood flow and are helpful to improve embryo implantation and clinical pregnancy rate.
关键词
子宫内膜 /
超声检查 /
多普勒 /
彩色
Key words
Endometrium /
Ultrasonography, Doppler, color
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基金
湖北省宜昌市科技研究与开发项目（No:A12301-48）。
