宫腔输卵管超声造影宫腔置管术失败原因分析  

Analysis of the reasons for failure of intrauterine catheterization in hysterosalpingo contrast sonography

作　　者：李燕[1] 王金萍[1] LI Yan;WANG Jingping(Department of Ultrasound,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei,Anhui 230000,China)

机构地区：[1]安徽中医药大学第一附属医院超声科,安徽合肥230000

出　　处：《安徽医药》2020年第10期2003-2005,I0003,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省2018年度重点研究与开发计划(1804h08020248)。

摘　　要：目的分析宫腔输卵管超声造影宫腔置管术失败的原因。方法回顾分析2015年12月至2018年7月安徽中医药大学第一附属医院736例宫腔输卵管超声造影术病人资料,分别统计宫腔输卵管超声造影宫腔置管术顺利、失败的比例,对照超声引导、宫腔镜结果,分析置管失败的原因。结果736例病人中716例(97.28%)宫腔置管术顺利;3例(0.41%)置管困难;17例(2.3%)置管失败,其中2例(0.27%)因子宫过屈无法调节,2例(0.27%)因宫腔下段粘连,1例(0.13%)因后位瘢痕憩室子宫,3例(0.41%)因子宫畸形,1例(0.13%)因阴道斜隔,6例(0.81%)因球囊膨隆失败,1例(0.13%)因球囊封堵宫颈内口失败,1例(0.13%)为不明原因。结论子宫位置、宫腔占位、子宫畸形及宫腔粘连均是置管术的影响因素;经腹超声实时引导、综合使用腹部按压手法及宫腔器械调节可提高宫腔输卵管超声造影置管术的安全性、成功率及有效性。Objective To analyze the reasons for failure of intrauterine catheterization in hysterosalpingocontrast sonography(4 DHyCoSy).MethodsRetrospective analysis was performed on thedata of736 patients who underwent4 D-HyCoSy in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from December 2015 to July 2018.The rate of successful and failed uterine tubal catheterization was calculated,and the reasons for failure were analyzed by comparing the results of ultrasound guidance and hysteroscopy.ResultsAmong the 736 patients,716 cases(97.28%)completed the operation successfully;3 cases(0.41%)had catheterization difficulty;17 cases failed(2.3%),including 2 cases(0.27%)due to uterine hyperflexion and could not be adjusted,2 cases(0.27%)due to intrauterine adhesion,1 case(0.13%)due to a scar uterus diverticulum,3 cases(0.41%)due to uterine malformation,1 case(0.13%)due to vaginal inclined partition,6 cases(0.81%)due to balloon swelling,1 case(0.13%)due to balloon plugging,and 1 case failed for unknown reasonsConclusionThe location of the uterus,intrauterine occupations and adhesions are the influencing factors of intrauterine tubal catheterization The real-time guidance of abdominal ultrasound,combined use of abdominal compression and intrauterine instruments can improve the safety,success rate and effectiveness of the operation.

关 键 词：子宫输卵管造影术 超声检查 介入性 导管 留置 宫腔置管术 宫腔粘连 子宫探针 扩宫棒 

分 类 号：R711.76[医药卫生—妇产科学]