本文關(guān)鍵詞： 黃素化未破裂卵泡綜合癥 卵泡期 卵巢血流 三維能量多普勒超聲　出處：《廣州中醫(yī)藥大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 利用經(jīng)陰道三維超聲及VOCAL后處理軟件對LUFS患者卵巢基礎(chǔ)狀態(tài)及卵泡期卵巢血流進行研究,評估LUFS患者的卵巢儲備功能,探討卵泡期LUFS發(fā)生的血流灌注特點。 方法： 1、分析20例LUFS患者；以同期正常排卵者20例為對照組。 2、記錄入選者的一般情況：包括年齡、身高、體重、不孕年限。 3、在卵泡早期(月經(jīng)第3-5天)抽取基礎(chǔ)性激素六項,在卵泡早期、卵泡中期(卵泡約12-16mm)、圍排卵期(排卵前一天或預(yù)測排卵日前一天)行經(jīng)陰道超聲檢查,在二維超聲下測量入選者卵泡期的子宮內(nèi)膜厚度、記錄圍排卵期子宮內(nèi)膜類型；在能量多普勒模式下對雙側(cè)卵巢進行三維成像并儲存三維數(shù)據(jù),在VOCAL軟件下對卵巢及成熟卵泡的輪廓進行描記,完成后自動算出卵巢體積、卵巢及成熟卵泡2mm范圍內(nèi)能量多普勒血流參數(shù)VI、FI、VFI,啟動sonoAVC功能自動測量卵巢內(nèi)所有竇卵泡數(shù)目及直徑。 4、定量分析兩組上述各項指標(biāo)之間的差異。 結(jié)果： 1、兩組患者卵泡早期、中期及圍排卵期內(nèi)膜厚度比較差別無統(tǒng)計學(xué)意義。圍排卵期LUFS組患者子宮內(nèi)膜形態(tài)以B、C型為主；對照組患者子宮內(nèi)膜形態(tài)則以A型主。 2、兩組患者基礎(chǔ)性激素FSH、LH、E2、P、PRL、T比較,差別均無統(tǒng)計學(xué)意義。兩組中卵泡早期竇卵泡數(shù)目、卵巢體積、血流灌注參數(shù)VI、FI、VFI差別無統(tǒng)計學(xué)意義。 3、對照組優(yōu)勢側(cè)卵巢血流參數(shù)VI、FI、VFI隨著卵泡生長呈上升趨勢,卵泡期3個階段比較差別有顯著性差異(均為P=0.000)；卵泡中期、圍排卵期優(yōu)勢側(cè)卵巢血流參數(shù)VI、FI、VFI與非優(yōu)勢側(cè)卵巢比較差別有顯著性差異(3者均P0.01),卵泡早期兩組比較差別無明顯統(tǒng)計學(xué)意義。 4、LUFS組優(yōu)勢側(cè)卵巢血流參數(shù)VI、VFI在各期比較差別有統(tǒng)計學(xué)意義(分別為P=0.004, P=0.008), FI則無明顯周期性波動(P=0.139)；LUFS組與對照組在卵泡中期及圍排卵期血流參數(shù)VI、FI、VFI的差異均有統(tǒng)計學(xué)意義。圍排卵期成熟卵泡壁2mm范圍內(nèi)血流參數(shù)Ⅵ與同組優(yōu)勢卵巢血流參數(shù)比較差別有統(tǒng)計學(xué)意義(P=0.045)、與對照組相應(yīng)部位血流參數(shù)VI、FI、VFI匕較差異均有統(tǒng)計學(xué)意義(分別為P=0.000,P=0.017,P=0.000)。對照組成熟卵泡血流分級主要以3-4級為主,LUFS組血流分級多呈1-2級。 結(jié)論： 1、LUFS患者卵巢儲備功能與正常排卵者相近。 2、正常排卵者優(yōu)勢側(cè)卵巢及優(yōu)勢卵泡周圍的血流灌注參數(shù)VI、FI、VFI隨著卵泡發(fā)育逐漸升高,提示正常成熟卵泡的成熟、排出需要豐富血供。 3、LUFS患者優(yōu)勢側(cè)卵巢圍排卵期血流較前豐富,但仍存在明顯不足。其成熟卵泡壁周圍血管數(shù)目較整個同側(cè)卵巢豐富,但低于對照組成熟卵泡。新生血管數(shù)量少,血流量低可能是導(dǎo)致LUFS發(fā)生的血流特點。 4、經(jīng)陰道三維能量多普勒超聲在探測卵巢血流灌注方面具有獨特優(yōu)勢,卵泡期進行經(jīng)陰道三維掃查有助于早期識別病理性卵泡發(fā)育及排卵障礙。
[Abstract]:Objective:. The basic status of ovary and ovarian blood flow in follicular phase of LUFS patients were studied by transvaginal three-dimensional ultrasound and VOCAL post-processing software. The ovarian reserve function of LUFS patients was evaluated and the perfusion characteristics of LUFS in follicular phase were investigated. Methods:. 1. 20 cases of LUFS were analyzed, and 20 cases of normal ovulation were taken as control group. 2, record the general situation of the selected: including age, height, weight, infertility. 3. Six basic sex hormones were extracted early in the follicle (day 3-5 of menstruation), and transvaginal sonography was performed in the early follicle, in the middle of the follicle (about 12-16 mm of follicle, in periovulation period (the day before ovulation or the day before the predicted day of ovulation)). The thickness of endometrium in follicular phase was measured under two-dimensional ultrasound, and the type of endometrium in periovulation phase was recorded. Three-dimensional imaging of bilateral ovaries and storage of 3D data were performed in the mode of power Doppler. The outline of ovaries and mature follicles was recorded by VOCAL software. The volume of ovaries and the parameters of energy Doppler flow in 2 mm range of ovary and mature follicles were calculated automatically. The number and diameter of all antral follicles in ovary were measured automatically by initiating sonoAVC function. 4. Quantitative analysis of the difference between the two groups. Results:. 1. There was no significant difference in endometrial thickness between the two groups in early follicular stage, middle follicle stage and peri-ovulation stage. In LUFS group, the endometrial morphology was mainly type C in periovulatory phase, while that in control group was type A. (2) there was no significant difference in the number of antral follicles, ovarian volume and blood perfusion parameters (VIFI) between the two groups. 3. The VFI of the dominant side of the control group showed an increasing trend with follicular growth, and there were significant differences in the three stages of follicular stage (all P < 0.000, P < 0.05), and in the middle stage of follicle, there were significant differences between the three stages of follicular stage. There were significant differences in VFI and non-dominant ovaries between the two groups in periovulatory period (P 0.01), but there was no significant difference between the two groups in early follicular stage. 4 there were significant differences in VIFI between the LUFS group and the control group in all stages (P 0.004, P < 0.008), but there was no significant periodic fluctuation in fi between the LUFS group and the control group in the midfollicular and peri-ovulation stages. The VIFIVFI was significantly different between the two groups in the middle follicular stage and the periovulation stage (P < 0.05). The blood flow parameters of VIFIVFI in the midfollicular and periovulation stage were significantly different between the control group and the control group (P < 0.05). There were significant differences between the blood flow parameters of the mature follicle wall within 2 mm and the dominant ovarian blood flow parameters of the same group (P < 0.045), and the blood flow parameters of the corresponding parts of the control group were significantly different from those of the control group (respectively) (P < 0.05). The blood flow grade of mature follicles in the control group was 3-4 grade and 1-2 grade in LUFS group. Conclusion:. 1Ovarian reserve function in LUFS patients was similar to that in normal ovulation patients. 2. The blood perfusion parameters of the dominant ovaries and peridominant follicles in normal ovulation patients increased with the follicular development, suggesting that the normal mature follicles need abundant blood supply. (3) the blood flow in the periovulatory stage of the dominant ovary of LUFS patients was more abundant than that in the control group, but there were still obvious deficiencies. The number of blood vessels around the wall of the mature follicle was more than that of the whole ipsilateral ovary, but lower than that of the control group, and the number of neovaries was less. Low blood flow may be the characteristic of LUFS. 4. Transvaginal three-dimensional power Doppler ultrasound has a unique advantage in detecting ovarian blood perfusion. Three-dimensional transvaginal scanning in follicular phase is helpful for early identification of pathological follicle development and ovulation disorders.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R711.6;R445.1

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