临床误诊误治2025，Vol.38Issue(2)：25-28,4.DOI:10.3969/j.issn.1002-3429.2025.02.006
不典型宫腔粘连超声误漏诊分析
Analysis of Ultrasonic Misdiagnosis of Atypical Uterine Adhesions
摘要
Abstract
Objective To analyze the causes of ultrasonic misdiagnosis of atypical uterine adhesions and to improve the level of clinical diagnosis and treatment.Methods The clinical data of 40 patients with intrauterine adhesions treated from June 2021 to June 2023 were retrospectively analyzed.Results Among the 40 cases,18 cases of infertility were diag-nosed as chronic pelvic inflammatory disease and fallopian tube obstruction,and were still infertile after symptomatic treat-ment.9 cases of recurrent spontaneous abortion were admitted to hospital.12 cases were admitted to hospital with abnormal menstruation.After 5 days of symptomatic treatment in other hospitals,there was no improvement in 1 patient admitted to hos-pital.Transvaginal ultrasonography was performed in all 40 cases.The initial diagnosis was intrauterine adhesions in 23 cases,endometrial polyps in 1 case,endometrial cancer in 1 postmenopausal woman,and no uterine abnormalities in 15 cases.23 cases of intrauterine adhesions were preliminarily diagnosed by ultrasonography and separated by intrauterine adhesions.15 ca-ses of normal uterus were initially diagnosed by ultrasonography.Hysteroscopy was performed to confirm intrauterine adhesions and intrauterine adhesions separation.One case was initially diagnosed as endometrial polyp by ultrasound.Hysteroscopic ex-traction of endometrial polyp and submucous myoma combined with intrauterine adhesions was found,and intrauterine adhe-sions separation was performed.One case of postmenopausal woman was diagnosed as endometrial cancer by ultrasound,and confirmed as uterine adhesions and pyosis by hysteroscopy,and then underwent hysteroscopic cervical dilation.Among the 40 cases,16 cases were misdiagnosed and 1 case was missed.The misdiagnosis rate was42.50％(17/40),and the misdiagno-sis time was 3 d-8 years.After follow-up for 12 months,30 cases of symptoms disappeared or improved significantly,4 cases of symptoms did not improve significantly,6 cases of uterine adhesions recurred,and hysteroscopic adhesions separation was performed again.Conclusion Ultrasonic misdiagnosis rate of atypical intrauterine adhesions is high.For patients with uterine surgery and overdue menstruation,the possibility of intrauterine adhesions should be vigilant,and hysteroscopy should be rec-ommended as soon as possible for patients with suspected lesions to avoid misdiagnosis.关键词
宫腔粘连/超声/误诊/漏诊/盆腔炎/子宫息肉/子宫内膜肿瘤/鉴别诊断Key words
Intrauterine adhesion/Ultrasound/Misdiagnose/Missed diagnosis/Pelvic inflammatory disease/Uter-ine polyps/Endometrial tumor/Differential diagnosis分类
医药卫生引用本文复制引用
王瑞萍,李楠,赵运清,曾立叶,毛秀菊..不典型宫腔粘连超声误漏诊分析[J].临床误诊误治,2025,38(2):25-28,4.基金项目
邢台市重点研发计划项目(2022ZC163) （2022ZC163）
