125例不孕症RT-3D-HyCoSy时发生造影剂逆流的影响因素分析  

Analysis of Factors Influencing the Occurrence of Contrast Reflux during RT-3D-HyCoSy in 125 Cases of Infertility

作　　者：李冰 陈晓艺[1] 林欣 王金萍[1] 张靖[1] LI Bing;CHEN Xiaoyi;LIN Xin(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院超声医学科,安徽合肥230031

出　　处：《河北医学》2024年第9期1560-1566,共7页Hebei Medicine

基　　金：安徽省重点研究和开发计划项目,(编号:1804h08020248)。

摘　　要：目的:分析不孕症女性经阴道实时三维超声子宫输卵管造影(real-time three-dimensional hysterosalpingo-contrast sonography,RT-3D-HyCoSy)时发生造影剂逆流的影响因素,为造影剂逆流防治提供参考。方法:收集2022年1月至2023年9月于我院接受RT-3D-HyCoSy检查的125例不孕症患者的病例资料,根据是否发生造影剂逆流将其分为造影剂逆流组(n=21)及造影剂未逆流组(n=104),单因素及多因素Logistic回归分析RT-3D-HyCoSy时发生造影剂逆流的危险因素。结果:造影剂逆流组患者不孕类型为继发、有宫内手术史、有子宫腺肌症、有异位妊娠史、有附件包块、有子宫畸形、中重度造影剂推注压力、子宫内膜厚度≤3.5mm、输卵管阻塞、造影时间为经期后≤5d的占比高于造影剂未逆流组,差异均有统计学意义(P均<0.05);继发型不孕(OR=2.088,95%CI=1.119~3.893,P=0.021)、有异位妊娠史(OR=2.061,95%CI=1.136~3.739,P=0.018)、子宫内膜厚度≤3.5mm(OR=2.319,95%CI=1.186~4.533,P=0.014)、输卵管阻塞(OR=2.109,95%CI=1.259~3.531,P=0.005)为不孕症女性RT-3D-HyCoSy时出现造影剂逆流的危险因素(P<0.05)。结论:继发型不孕、异位妊娠史、子宫内膜厚度≤3.5mm及输卵管阻塞是不孕症女性RT-3D-HyCoSy检查时发生造影剂逆流的危险因素;临床需重点关注合并上述危险因素不孕症RT-3D-HyCoSy检查时造影剂逆流的预防。Objective:To analyze the influencing factors of contrast agent reflux in infertile women during transvaginal real-time three-dimensional hysterosalpingo-contrast sonography(RT-3D-HyCoSy),and to provide a reference for the prevention and treatment of contrast agent reflux.Methods:The case data of 125 patients of infertility who received RT-3D-HyCoSy examination in the hospital were collected from January 2022 to September 2023.According to whether contrast agent reflux occurred,they were divided into the contrast agent reflux group(n=21)and the contrast agent non-reflux group(n=104).Univariate analysis and multivariate Logistic regression analysis were used to analyze the risk factors of contrast agent reflux during RT-3D-HyCoSy.Results:The proportions of patients with secondary infertility,history of intrauterine surgery,adenomyosis,history of ectopic pregnancy,adnexal mass,uterine deformity,moderate-to-severe contrast agent injection pressure,endometrial thickness≤3.5 mm,tube obstruction,and angiography time≤5 days after menstruation were higher in contrast agent reflux group than those in contrast agent non-reflux group(all P<0.05).Secondary infertility(OR=2.088,95%CI=1.119~3.893,P=0.021),history of ectopic pregnancy(OR=2.061,95%CI=1.136~3.739,P=0.018),endometrial thickness≤3.5 mm(OR=2.319,95%CI=1.186~4.533,P=0.014)and tube obstruction(OR=2.109,95%CI=1.259~3.531,P=0.005)were the risk factors of contrast agent reflux in infertility women during RT-3D-HyCoSy(P<0.05).Conclusion:Secondary infertility,history of ectopic pregnancy,endometrial thickness≤3.5 mm,and tube obstruction are risk factors of contrast agent reflux in women with infertility during RT-3D-HyCoSy examination.It is necessary to pay clinical attention to the prevention of contrast agent reflux during RT-3D-HyCoSy examination in infertile women using the above risk factors.

关 键 词：不孕症 实时三维超声子宫输卵管造影 造影剂逆流 

分 类 号：R711.6[医药卫生—妇产科学]