经阴道子宫输卵管四维超声造影对不孕症患者输卵管通畅性的诊断价值研究  

Diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography for assessing tubal patency in patients with infertility

作　　者：王斯彬 陈仙秋 Wang Sibin;Chen Xianqiu(Department of Utrasound,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Zhejiang Chinese Medical University,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]浙江中医药大学附属温州中西医结合医院超声科,温州325000

出　　处：《中国基层医药》2024年第10期1490-1494,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省温州市基础性科研项目(Y20190676)。

摘　　要：目的探讨经阴道子宫输卵管四维超声造影(4D-HyCoSy)对不孕症患者输卵管通畅性的诊断价值。方法回顾性选择2019年6月至2022年6月在浙江中医药大学附属温州中西医结合医院诊断为不孕症患者160例为研究对象,患者均进行4D-HyCoSy检查,以输卵管通液术检查结果为金标准,评价4D-HyCoSy检查对不孕症患者输卵管通畅性的诊断效能,观察不同输卵管通畅程度下造影剂盆腔弥散和卵巢周围包绕情况的差异,记录4D-HyCoSy检查过程中患者不良反应情况。结果4D-HyCoSy检查对于不孕症患者输卵管通畅、通而不畅、阻塞等诊断符合率分别为90.07%(127/141)、92.10%(105/114)和93.85%(61/65),4D-HyCoSy检查对于不孕症患者输卵管通畅性诊断灵敏度、特异度和准确度分别为93.85%(61/65)、99.22%(253/255)和98.12%(314/320);不同输卵管通畅程度在造影剂盆腔弥散和卵巢周围包绕方面差异均有统计学意义(χ^(2)=411.58、286.32,均P<0.001);4D-HyCoSy检查过程患者轻微疼痛反应发生率为18.12%(29/160),且未见其他不良反应。结论4D-HyCoSy检查不良反应少,安全性高,诊断结果与输卵管通液术检查具有较高一致性,是进行不孕症患者输卵管通畅性评估与诊断的有效方法。Objective To investigate the diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography(4D-HyCoSy)in assessing tubal patency in patients with infertility.Methods A total of 160 patients with infertility diagnosed at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Zhejiang Chinese Medical University,from June 2019 to June 2022 were retrospectively included in this study.All patients underwent 4D-HyCoSy examinations.The results of hydrotubation were used as the gold standard to evaluate the diagnostic efficacy of 4D-HyCoSy for assessing tubal patency in patients with infertility.The differences in the pelvic dispersion of the contrast agent and the surrounding conditions of the ovaries were evaluated across varying degrees of tubal patency.Any adverse reactions experienced by patients during the 4D-HyCoSy examination were recorded.Results The diagnostic agreement rates of 4D-HyCoSy for assessing tubal patency,partial patency,and obstruction in patients with infertility were 90.07%(127/141),92.10%(105/114),and 93.85%(61/65),respectively.The sensitivity,specificity,and accuracy of 4D-HyCoSy examination for diagnosing tubal patency in patients with infertility were 93.85%(61/65),99.22%(253/255),and 98.12%(314/320),respectively.Statistically significant differences were observed in the pelvic dispersion of the contrast agent and the surrounding conditions of the ovaries across varying degrees of tubal patency(χ^(2)=411.58,286.32,both P<0.001).The incidence of mild pain during the 4D-HyCoSy examination was 18.12%(29/160),with no other adverse reactions reported.Conclusion 4D-HyCoSy has a low incidence of adverse reactions and high safety.Its diagnostic results show a high level of consistency with hydrotubation results,making it an effective method for assessing and diagnosing tubal patency in patients with infertility.

关 键 词：不育 女(雌)性 腔内超声检查 输卵管 诊断 安全 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.6[医药卫生—诊断学]