子宫输卵管超声重复造影评价输卵管通畅性的临床价值

Clinical value of repeated hysterosalpingo contrast sonography in evaluating patency of fallopian tube

摘要:

目的 分析重复四维子宫输卵管超声造影在评价输卵管通畅性的可行性及临床价值。方法 选取 2015年1月—2018年7月于青岛市市立医院行四维子宫输卵管超声造影检查，且结果显示单侧或双侧输卵管完全 阻塞的140例患者作为研究对象。按照自愿原则分为单次造影组和重复造影组，比较两组检查结果与腹腔镜检查 结果的一致性，分析重复造影与单次造影结果不一致患者的临床资料，比较两组患者的不良反应情况。结果 单 次造影组、重复造影组与腹腔镜检查结果的符合率分别为87.9%和95.2%，单次造影组的Kappa值为0.760，与腹 腔镜检查结果的一致性良好，重复造影组的Kappa值为0.905，与腹腔镜检查结果的一致性很好。结果不一致组的 子宫水平位及输卵管远端阻塞的比例、置管深度/内膜线长度、球囊注水量较结果一致组高（P <0.05）。重复造影 组NRS疼痛评分较单次造影组高（P <0.05）。结论 四维子宫输卵管超声造影检查显示单侧或双侧阻塞患者可行 重复造影检查，以提高造影结果的准确性。

Abstract:

Objective To analyze the feasibility and clinical value of repeated 4D-hysterosalpingo contrast sonography in evaluating the patency of fallopian tube. Methods The patients who have complete obstruction of unilateral or bilateral fallopian tubes by 4D-HyCoSy inspection in our hospital from January 2015 to July 2018 were selected as the research objects. The patients were divided into the single angiography group and repeat angiography group according to the principle of voluntary selection. The consistency of examination results between the two groups and the results of laparoscopy was compared, and the clinical data of patients with inconsistent results of repeat angiography and single angiography were analyzed, while the adverse reactions of patients in the two groups were compared. Results The coincidence rate of single angiography and repeat angiography with laparoscopy was 87.9% and 95.2%. The results of single angiography had good consistencies with the results of laparoscopy (Kappa = 0.760), but the repeat angiography was better (Kappa = 0.905). The proportion of horizontal uterine and distal fallopian tube obstruction, tube depth/intimal line length, and balloon volume were significantly higher in patients with two inconsistent angiography results than in patients with two consistent angiography results (P < 0.05). NRS pain scores of patients in the repeat angiography group were significantly higher than those in the single angiography group (P < 0.05). Conclusion The repeated 4D-HyCoSy was used in patients with unilateral or bilateral fallopian tubes obstruction in order to improve the accuracy of imaging results.