The Effect Of Mechanical Stimulation On The Cervix To Uterine Artery Hemodynamics In Patients With Endometriosis

Objectives:Observe the influence of mechanical stimulation on the cervix to uterine artery hemodynamics in patients with endometriosis and to explore its clinical significance.Methods:Collected normal women and EMs patients with a total of 65 cases as the research object during the period of January 2014 and September 2014, these 65 people will be divided into two groups,32 cases in the endometriosis group and 33 cases in the normal group. All the postoperativel and intraoperative pathologic results were endometriosis in the endometriosis group, and no Gynecological diseases in the normal group.They were all at the age of 24 to 45 years old, had not been endocrine therapy and surgery, at endometrial proliferation stage. Uterine artery hemodynamics parameters of the two groups of patients were measured by the same B-room physicians with the same GEVo Luson E8 color Doppler in our hospital with the transabdominal probe of 3.5Hz. Provided that the two groups of patients with right amount full bladder and chose the position of supine.The uterine artery hemodynamics parameters includs Peak systolic velocity(PSV), end-diastolic velocity(EDV), resistance index(RI), pulsatility index(PI).Bimanual examination stimulation were performed by the same clinician after the measurement:palce left hand on patient’s abdomen pressure on the bottom of the uterus, two fingers of right hand into the vagina to swing the cervix up and down five times.Swinging the cervix forward if the uterus is anterior,and Swinging the cervix backward if the uterus is posterior, amplitude of the swings is about 30-45 °.Observed the same vascular with the abdominal probe after the swings. Measure the blood flow spectrum(PSV 、 EDV 、 PI 、 RI) between the time after the bimanual examination 15s-20 s.Compared the changes of uterine artery hemodynamics parameters before and after swing the cervix in normal women and patients with endometriosisResults:1.The difference in the normal group between before and after swing the cervix: PSV(45.47±21.74) cm/s, EDV(7.68±3.86)cm/s, PI(2.07±0.54),RI(0.81±0.09)and PSV(52.85 ±23.27)cm/s,EDV(7.22±4.93)cm/s,PI(2.34±0.52),RI( 0.83 ± 0.10) has not statistically significant(P> 0.05).2.The difference in the endometriosis group between before and after swing the cervix: PSV(52.61±15.18)cm/s,PI(2.07±0.52) and PSV(49.41±13.42)cm/s, PI( 2.31± 0.64) has no statistically significant(P> 0.05), but the difference between before and after swing the cervix: EDV(8.06±4.14)cm/s,RI(0.84±0.08)and EDV(4.95±3.99)cm/s, RI(0.90±0.89) has statistically significant(P <0.05).Conclusion:The end-diastolic velocity and the resistance index in normal women after swing the cervix did not change significantly,but the end-diastolic velocity of endometriosis patients reduced and the vascular resistance index increased obviously after swing the cervix, and the resistance index higher in endometriosis patients than normal women after swing the cervix. Conclusion: the uterine artery of endometriosis patients is more sensitive than normal women to mechanical stimulation,and the uterine artery blood flow decrease caused by the mechanical stimulation in endometriosis patients.