彩色多普勒超声诊断生殖器外伤的研究

发布时间：2019-04-26 00:18

【摘要】：目的:探讨彩色多普勒对生殖器外伤的诊断,治疗预后评价情况。方法:对我院于2009年6月--2012年12月60例生殖器外伤临床资料进行回顾性分析。本组60例中,其中睾丸外伤20例,睾丸破裂型3例,睾丸血肿型4例,睾丸挫伤型8例,睾丸炎型3例,睾丸扭转2例。女性生殖器外伤40例,其中合并宫外孕破裂20例,合并黄体破裂15例,合并卵巢囊肿扭转5例。结果本组60例经二维超声和彩色多普勒检查患者中,随访时间1天--30天,平均7天。其中睾丸破裂及睾丸扭转均手术治疗;睾丸血肿,睾丸挫伤,睾丸炎型保守治疗;女性生殖器外伤,其中宫外孕破裂14例,8例黄体破裂及3例卵巢囊肿扭转均手术治疗,6例宫外孕,7例黄体破裂保守治疗。结论彩色多普勒是生殖器外伤重要的诊断方法,超声造影有助于治疗后评价疗效;PW示峰值血流速度(Vmax),阻力指数(RI)对生殖器外伤的诊断价值及预后评价,血、尿HCG检查是区别宫外孕和黄体破裂重要指标;大于1/3睾丸破裂及睾丸扭转,实质内未探及血流信号或较健侧明显减少,必须手术治疗;小于1/3睾丸破裂、睾丸挫伤,睾丸血肿、睾丸炎均可保守治疗,但是当病情出现进一步加重时要及时手术。生殖器外伤合并卵巢囊肿扭转,其内未探及血流信号或血流阻力指数非常高时须手术治疗,合并宫外孕及黄体破裂时,出血量不多时可保守治疗,出血量非常多时必须手术。
[Abstract]:Objective: to evaluate the diagnosis and prognosis of genital trauma by color Doppler. Methods: the clinical data of 60 cases of genital trauma in our hospital from June 2009 to December 2012 were analyzed retrospectively. Among the 60 cases, there were 20 cases of testicular trauma, 3 cases of testicular rupture, 4 cases of testicular hematoma, 8 cases of testicular contusion, 3 cases of testicular inflammation and 2 cases of testicular torsion. There were 40 cases of female genital trauma, including 20 cases with extrauterine pregnancy rupture, 15 cases with corpus luteum rupture and 5 cases with ovarian cyst torsion. Results the follow-up time ranged from 1 day to 30 days (mean 7 days) in 60 patients who were examined by two dimensional ultrasound and color Doppler. Among them testicular rupture and testicular torsion were treated surgically, testicular hematoma, testicular contusion, testicular inflammation type conservative treatment; There were 14 cases of extrauterine pregnancy rupture, 8 cases of corpus luteum rupture and 3 cases of ovarian cyst torsion, 6 cases of ectopic pregnancy and 7 cases of conservative treatment. Conclusion Color Doppler is an important diagnostic method for genital trauma. Contrast-enhanced ultrasound is helpful to evaluate the curative effect after treatment. The value of PW peak flow velocity (Vmax), resistance index (RI) in diagnosis and prognosis of genital trauma was evaluated. HCG examination in blood and urine was an important index to distinguish ectopic pregnancy and corpus luteum rupture. More than 1 / 3 testicular rupture and testicular torsion, the blood flow signal was not detected in the parenchyma or decreased significantly compared with the healthy side, which must be treated surgically. Testicular rupture, testicular contusion, testicular hematoma and orchitis can be treated conservatively. The genital trauma complicated with ovarian cyst torsion should be treated surgically when the blood flow signal is not detected or the resistance index of blood flow is very high. In the case of extrauterine pregnancy and rupture of the corpus luteum, it can be treated conservatively when the amount of bleeding is not much, and the operation must be done when the volume of bleeding is very large.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R699

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