4D-HyCoSy对疑似输卵管因素不孕症患者自然受孕的指导价值  

The guiding value of 4D-HyCoSy for natural conception in patients with suspected tubal factor infertility

作　　者：武依娜 王召朋 周晓燕[1] 汤美玲[1] WU Yi-na(Wanbei Coal-electricjty Group General Hospital,Suzhou 234000,China)

机构地区：[1]皖北煤电集团总医院,安徽宿州234000

出　　处：《牡丹江医学院学报》2022年第6期65-69,101,共6页Journal of Mudanjiang Medical University

基　　金：蚌埠医学院自然科学重点项目(BYKY2019243ZD)。

摘　　要：目的 探讨经阴道四维子宫输卵管超声造影(four-dimensional hysterosalpingography, 4D-HyCoSy)检查对疑似输卵管因素不孕症患者输卵管通畅度的诊断价值及自然受孕的预测价值,并评估其安全性。方法 选取2019年10月至2020年12月间,于皖北煤电集团总医院生殖医学科自愿行子宫输卵管X线造影检查(Hysterosalpingography, HSG)和经阴道4D-HyCoSy检查的不孕患者,分别为374例与351例,根据检查结果,均分为单侧通畅组(A组,123例与94例)、双侧通畅组(B组,104例与86例)、一侧通而不畅一侧不通组(C组,50例与59例)、双侧通而不畅组(D组,63例与85例)以及双侧不通组(E组,34例与27例),评估患者检查术中术后不良反应,随访6个月,统计患者自然受孕情况并分析两种检查的诊断价值和安全性。结果 HSG检查A组与D组患者人流综合征发生率、疼痛数值评定量表评分法(Numerical rating scale, NRS)以及Stacey分级,均较4D-HyCoSy检查A组与D组升高,而自然受孕率则较低(P<0.05);HSG检查与4D-HyCoSy检查B组、C组、E组的人流综合征发生率、NRS及Stacey分级无统计学差异,其中两种检查C组与E组自然受孕率无显著差异(P>0.05),而4D-HyCoSy B组自然受孕率高于HSG检查B组(P<0.05)。结论 经阴道4D-HyCoSy检查部分术中、术后出现不良反应的评估相比传统HSG检查少,对输卵管通畅和部分输卵管通畅度欠佳患者自然受孕预测的准确度更高,可更准确评估辅助生殖技术(Assisted reproductive technology, ART)的必要性,对疑似输卵管因素不孕症患者的后续治疗更具有指导意义。Objective To investigate the diagnostic value of TVS four-dimensional hysterosalpingography(4D-HyCoSy)examination for tubal patency in patients with suspected tubal factor infertility,and evaluate the predictive value of natural conception and its safety.Methods 374 cases of infertility who underwent hysterosalpingography(HSG)and 351 cases of infertility who underwent TVS 4D-HyCoSy examination were selected from October 2019 to December 2020 in the Reproductive Medicine Center,Wanbei Coal-electricity Group General Hospital,.According to the examination results,all cases were divided into unilateral fallopian tube patency group(group A,123 cases and 94 cases),bilateral fallopian tube patency group(group B,104 cases and 86 cases),one fallopian tube patency but one side fallopian tube obstruction group(group C,50 cases and 59 cases),bilateral fallopian tube obstruction group(group D,63 cases and 85 cases)and bilateral fallopian tube obstruction group(group E,34 cases and 27 cases).Assessment Check for intraoperative and postoperative adverse effects.After 6 months of follow-up,the patients,natural conception was counted,and the diagnostic value and safety of the two tests were analyzed.Results Compared with those in 4D-HyCoSy examination of unilateral tubal patency group and bilateral tubal patency group,the incidence of abortion syndrome,NRS and Stacey grading with HSG examination were increased,while the natural conception rate was lower(P<0.05).HSG examination and 4D-HyCoSy examination showed no significant difference in the incidence of abortion syndrome,NRS and Stacey grading of bilateral patency group,one side patency group,one side barrier group and bilateral barrier group.In addition,there was no significant difference in the natural conception rate between the two-sided barrier group and the bilateral barrier group(P>0.05).However,the spontaneous pregnancy rate in the bilateral patency group examined by 4D-HyCoSy was higher than that in the bilateral patency group examined by HSG(P<0.05).Conclusion Compared

关 键 词：不孕症 超声造影 输卵管 自然受孕 

分 类 号：R715.2[医药卫生—妇产科学]