经阴道实时三维子宫输卵管超声造影在不孕症患者输卵管通畅性评价中的应用价值  

Application value of transvaginal real-time 3D-Hy Co Sy in the evaluation of tubal patency in infertility

作　　者：石秀玲[1] 张巍 王丹[1] 徐亚莉 杨帆[1] 王茵 何学南 SHI Xiu-ling;ZHANG Wei;WANG Dan;XU Ya-li;YANG Fan;WANG Yin;HE Xue-nan(Department of Ultrasound,Langfang People＇s Hospital,Langfang Hebei 065000,P.R.China)

机构地区：[1]廊坊市人民医院超声科,河北廊坊065000

出　　处：《中国计划生育和妇产科》2018年第11期88-91,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：廊坊市科学技术局自筹经费项目(项目编号:2018013070)

摘　　要：目的探究分析经阴道实时三维输卵管超声造影(three-dimensional hysterosalpingo contrast sonography,3D-Hy Co Sy)在评价不孕症输卵管通畅性中的应用价值及安全性。方法 2016年6月至2017年12月廊坊市人民医院收治的240例不孕症患者(478条输卵管)均采用经阴道实时3D-Hy Co Sy进行输卵管通畅性检查,观察经阴道实时3D-Hy Co Sy的图像质量和检查结果,从240例患者中选取80例患者再进行腹腔镜下通染试验,通过对比评价经阴道实时3D-Hy Co Sy的应用价值,采用疼痛视觉模拟评分(Visual Analogue Scale,VAS)对患者在检查结束时的疼痛程度进行评价并记录不良反应。结果经阴道实时3D-Hy Co Sy检查获得的图像质量均为优良,其中有20例患者经2次检查后获得优良图像。经阴道实时3D-Hy Co Sy评价输卵管通畅性的敏感度为81. 13%(86/106),特异性为96. 30%(52/54),检查准确率为86. 25%;一致性检验Kappa值为0. 793(P <0. 05)。经阴道实时3D-Hy Co Sy检查患者的VAS评分为(3. 25±1. 26),腹腔镜下通染试验患者的VAS评分为(5. 41±1. 53),两组间比较差异有统计学意义(P <0. 05)。结论经阴道实时3DHy Co Sy在不孕症输卵管的通畅性检查时,与腹腔镜下通染试验结果有良好的一致性,且操作方便,给患者带来的疼痛小,图像结果能直观反复观察。实时3D-Hy Co Sy检查作为不孕症患者病因筛查的新方法,值得临床推广。Objective To explore the application value and safety of transvaginal real-time 3 D-Hy Co Sy in the evaluation of tubal patency. Methods From June 2016 to December 2017,240 cases of infertile patients（ 478 fallopian tubes） in Langfang People＇s Hospital were treated with vaginal real-time 3 D-Hy Co Sy for tubal patency,and the image quality and examination results were observed through vaginal real-time 3 D-Hy Co Sy. The clinical value of transvaginal real-time 3 D-Hy Co Sy was evaluated by contrast in 80 patients selected from 240 patients,and the VAS score was used to evaluate the pain level of patients at the end of examination and to record adverse reactions. Results The image quality obtained by transvaginal real-time 3 D-Hy Co Sy examination was excellent,among which 20 patients obtained excellent images after two examinations. The sensitivity of fallopian tube patency was81. 13 %（ 86/106）,the specificity was 96. 30 %（ 52/54）,the accuracy of 3 D-Hy Co Sy was 86. 25 %,and the consistency test Kappa value was 0. 793（ P〈0. 05）. The VAS score of the patients who underwent transvaginal real-time 3 D-Hy Co Sy examination was（ 3. 25 ± 1. 26）,and the VAS score of the patients underwent laparoscopic perfection test was（ 5. 41 ± 1. 53）. The difference between the two groups was statistically significant（ P〈0. 05）. Conclusion Transvaginal real-time 3 D-Hy Co Sy is in good agreement with laparoscopic communication test in the patency of infertility tubal. Moreover,the operation is convenient,the pain brought to the patient is small,and the image results can be visually and repeatedly observed. Real-time 3 D-Hy Co Sy examination is a new method for screening patients with infertility and it is worthy of clinical promotion.

关 键 词：不孕症 输卵管超声造影 输卵管通畅性 

分 类 号：R711.6[医药卫生—妇产科学]