子宫输卵管造影中静脉逆流与造影剂剂型及子宫内膜厚薄的相关性研究

Correlation between venous reflux,contrast agent and endometrial thickness in hysterosalpingography

目的:分析子宫输卵管造影静脉逆流与造影剂剂型选择及子宫内膜厚度的关系。方法:回顾分析1066例2009年8月至2013年5月来门诊并行子宫输卵管造影诊断的不孕症患者的临床诊治资料,并根据造影剂的使用剂型,将患者分为两组:碘化油组584例,碘海醇组482例。造影前4h应用B超测量子宫内膜厚度,分析不同年龄、造影剂及不同子宫内膜厚度对造影剂静脉逆流的影响并进行相关性分析。结果:在行HSG术时发生静脉逆流71例,经统计学分析可知不同造影剂和子宫内膜厚度对静脉逆流的发生例数影响具有统计学意义(P分别为0.0058、0.0005),子宫内膜厚度与静脉逆流的发生例数呈负相关性(r=-0.872,P=0.002);而静脉逆流的发生例数与造影剂剂型呈相关性(r=0.610,P=0.010)。结论:HSG静脉逆流和造影剂剂型及子宫内膜的厚度存在一定的相关性。在行HSG检查前,应首先了解患者子宫内膜的厚度情况并尽可能选择子宫内膜在6mm左右时检查;掌握水溶性造影剂适当的注射压、流速及剂量,可以降低造影剂逆流的发生率,提高HSG检查的安全性和准确性。

Objectives： To analyze the relationship between venous reflux, eontrast agent and endometrial thickness in hys- temsalpingography （HSG）. Method： Retrospective analysis was carried out based on 1066 cases of infertility from Aug 2009 to May 2013. The patients were divided into iodinated oil group （582 cases） and iohexol group （482 cases） according to the types of contrast agent. Their endometrial thickness was meased by B ultrasound 4 hours before HSG. Determinants of venous reflux including age, contrast agent and endometrial thickness were analyzed to explore their correlation. Results： 71 cases of vein re flux occurred during HSG and different contrast agent and endometrial thickness had significam influence on vein reflux （P = 0. 0058,0. 0005, P 〈 0. 01 ）. Endometrial thickness had a negative correlation with venous reflux （ r = - 0. 872, P = 0. 002） while contrast agent had a positive correlated （ r = 0. 610, P = 0. 010）. Conclusion： Venous reflux had correlation with contrast agent and endometrial thickness in hysterosalpingography. Endometrial thickness should be measured before HSG examination, and the best of endometrial thickness is about 6ram in the HSG examination. Appropriate injection pressure, flow rate and dose should be administered when using water soluble contrast agent. Both of them can reduce the incidence of venous reflux, improve the safety and accuracy of HSG examination.