子宫输卵管超声造影中静脉逆流与输卵管通畅程度的关系及影响因素分析  

Analysis of the relationship between venous reflux and fallopian tubal patency in hysterosalpingo contrast sonography and its influencing factors

作　　者：杜中亮[1] 苏继红 鲁小娟 朱薇薇 DU Zhongliang;SU Jihong;LU Xiaojuan;ZHU Weiwei(Department of Ultrasound,Taicang Hospital of Traditional Chinese Medicine,Suzhou 215400,Jiangsu,China)

机构地区：[1]太仓市中医医院超声科,江苏苏州215400

出　　处：《中国性科学》2024年第5期98-102,共5页Chinese Journal of Human Sexuality

摘　　要：目的分析子宫输卵管超声造影(HyCoSy)中静脉逆流与输卵管通畅程度之间的相关性。方法选取2021年1月至2022年6月于太仓市中医医院接受HyCoSy检查的80例不孕患者作为研究对象,依据是否出现造影剂静脉逆流将患者分为逆流组(n=31)和无逆流组(n=49)。对比两组患者的输卵管通畅程度,通过多因素Logistic回归分析探究患者发生造影剂静脉逆流的独立影响因素,依据独立因素构建列线图预测模型,并对模型进行验证。使用X-tile软件确定预测模型的截断值,并建立生存曲线。结果逆流组患者双侧输卵管通畅类型为(A+A)型人数占比显著低于无逆流组(P<0.05),(B+C)和(C+C)型人数占比显著高于无逆流组(P<0.05)。子宫内膜厚度<5.45 mm、双侧输卵管通畅类型为(B+C)和(C+C)型为静脉逆流的危险因素(P<0.05),(A+A)型为保护因素(P<0.05)。利用独立影响因素构建的列线图预测模型具有较好的区分度和准确性。危险分层和生存曲线提示,随着总分的增加,患者造影剂静脉逆流的风险越高。结论输卵管阻塞越严重的患者造影剂静脉逆流的发生风险越高,子宫内膜厚度≥5.45 mm时行HyCoSy检查可有效降低造影剂逆流的发生率。Objective To analyze the correlation between the venous reflux and the fallopian tube patency in hysterosalpingo contrast sonography(HyCoSy).Methods A total of 80 infertile patients who were examined by HyCoSy in Taicang Hospital of Traditional Chinese Medicine from January 2021 to June 2022 were selected as study objects.The patients were divided into reflux group(n=31)and non-reflux group(n=49)according to whether there was contrast medium venous reflux.The fallopian tubes patency in the two groups was compared.The independent influencing factors of patients with contrast medium venous reflux were analyzed by multivariable Logistic analysis,and the nomogram prediction model was constructed based on independent factors,and the model was verified.X-tile software was used to determine the cut-off value of the prediction model and establish survival curve.Results The proportion of bilateral tubal patency type(A+A)patients in the reflux group was significantly lower than that in the non-reflux group(P<0.05),and the proportions of type(B+C)and(C+C)patients were significantly higher than those in the non-reflux group(P<0.05).Endometrial thickness<5.45 mm,bilateral tubal patency type(B+C)and(C+C)were independent risk factors for contrast medium venous reflux(P<0.05),and bilateral tubal patency type(A+A)was protective factor(P<0.05).The nomogram prediction model constructed by independent influencing factors has good discrimination and accuracy.Risk stratification and survival curves suggest the risk of contrast medium venous reflux increased with the total score increasing.Conclusions Patients with more severe obstruction of the fallopian tubes had a higher risk of contrast medium venous reflux.HyCoSy examination can effectively reduce the incidence of contrast medium reflux when the endometrial thickness is≥5.45 mm.

关 键 词：子宫输卵管超声造影 输卵管通畅程度 相关性 列线图模型 

分 类 号：R711[医药卫生—妇产科学]