经阴道实时三维超声子宫输卵管造影对输卵管通畅性的检查评价分析  

Transvaginal real-time three-dimensional echocardiography of hysterosalpingography to evaluate the fallopian tube patency

作　　者：黄晴[1] 练丹[1] 邱洪凤[1] 韦静[2] 

机构地区：[1]广西医科大学第四附属医院超声科,广西柳州545005 [2]广西医科大学第四附属医院妇产科,广西柳州545005

出　　处：《中国性科学》2017年第4期41-45,共5页Chinese Journal of Human Sexuality

基　　金：广西壮族自治区卫生厅科研课题项目(合同号:Z2013629)

摘　　要：目的:分析经阴道实时三维超声子宫输卵管造影(3D-Hy Co Sy)对输卵管通畅性的检查评价效果,为输卵管通畅性的准确评估提供新方法、新思路。方法:选取我院2015年1月至2016年1月收治的159例不孕症患者,运用经阴道实时3D-Hy Co Sy检查其输卵管通畅性,并与金标准腹腔镜通染液试验(CLP)检查结果进行比较,分析其图像质量及评价输卵管通畅性的灵敏度、特异性、准确性,并对两种检查方式费用、安全性等指标进行比较,探讨经阴道实时3D-Hy Co Sy的临床应用价值。结果:3D-Hy Co Sy图像中,110例(69.18%)图像质量优,32例(20.13%)图像质量良,优良率为89.31%(142/159),其余17例(10.69%)图像质量差,通过重复试验并结合二维实时监测亦可有效评价输卵管通畅性。经阴道实时3DHyC oS y检查后2d患者VAS评分为(3.25±1.26)分,显著低于CLP患者术后2d VAS评分(4.40±1.71)分,其检查总费用亦显著低于后者,差异有统计学意义(P<0.05)。以CLP检查结果为标准,经阴道实时3DHyC oS y评价输卵管通畅性的灵敏度为83.02%,特异性为98.11%,准确率为93.08%,一致性检验Kappa值为0.762(P<0.05)。结论:经阴道实时3D-HyC oS y具有安全、简便的优势,能够动态、立体明确输卵管结构、走行及阻塞部位,对输卵管通畅的评价具有积极意义,值得推广。Objectives:To analyze the evaluation of transvaginal real-time three-dimensional echocardiography of hysterosalpingography(3D-Hy Co Sy) on tubal patency,in order to provide new ideas and methods for the accurate assessment of tubal patency. Methods:159 infertile patients in our hospital from January 2015 to January2016 were selected and using transvaginal real-time 3D-Hy Co Sy to check the fallopian tube patency. The examination result was compared against that of the gold standard laparoscopic through dye test(CLP) examination results. The image quality was analyzed to evaluate the sensitivity,specificity and accuracy of the examination. The cost,security,and other indicators were also compared,to evaluate the clinical application of vaginal real-time 3D-Hy Co Sy. Results:Among the 3D-Hy Co Sy image,there were 110 cases(69. 18%) with excellent image quality,32 cases(20. 13%) with good image quality,and the remaining 17 cases(10. 69%) were with poor image quality,but with repeated tests and 2D real-time monitoring it can effectively evaluate the fallopian tube patency.After vaginal real-time 3D-Hy Co Sy inspection,the 2 d VAS score was(3. 25 ± 1. 26) points,significantly lower than that of postoperative 2 d VAS score(4. 40 ± 1. 71) points of CLP patients,and the total cost was also significantly lower than that of the latter examination,with statistically significant difference(P < 0. 05). The sensitivity,specificity,accuracy rate and consistency check Kappa value of the fallopian tube patency was 83. 02%,98. 11%,93. 08% and 0. 762 respectively(P < 0. 05),with the CLP test results as the standard. Conclusion:With the advantages of safe,simple and clear,transvaginal real-time 3D-Hy Co Sy can present the dynamic three-dimensional structure,running and tubal obstruction,which is of positive significance to the evaluation of fallopian tube patency and worthy of promotion.

关 键 词：经阴道实时三维超声 子宫输卵管造影 输卵管通畅性 不孕症 

分 类 号：R711.76[医药卫生—妇产科学]