三维子宫输卵管超声造影在诊断输卵管源性不孕中的应用评价

The application evaluation of three-dimensional hysterosalpingo-contrast sonography in the diagnose of fallopian tube infertility

目的评价三维子宫输卵管超声造影(3D-Hy Co Sy)在诊断输卵管源性不孕症中的应用价值。方法选择来我院门诊及生殖中心就诊的不孕症患者39例,采用3D-Hy Co Sy技术判断输卵管的通畅性,并记录不良反应。其中21例行腹腔镜下输卵管插管通液术,以此为标准,评价两种方法检查输卵管通畅程度的一致性。结果 139例女性不孕症患者中3例已行一侧输卵管切除,共75条输卵管行3D-Hy Co Sy检查,结果提示37条通畅,18条通而不畅,20条阻塞。其中21例42条输卵管又行腹腔镜输卵管通液术并以观察检查结果为标准,进行一致性检验,Kappa值为0.701,总体符合率为85.7%(36/42)。23D-Hy Co Sy检查过程中,39例患者中有无明显不适6例,轻微疼痛32例,明显疼痛1例,但能忍受,均顺利完成检查,结束后腹痛均缓解,无一例过敏反应发生。结论 3D-Hy Co Sy可以清晰显示输卵管通畅情况,简便易行,安全性高,在输卵管病变引起的不孕症的诊断中具有很好的临床应用价值。

Objective To evaluate the application value of the three-dimensional hysterosalpingo-contrast sonography（3D-HyCoSy）in the diagnosis of fallopian tube infertility. Methods All 39 patients with infertility in clinic and repro-ductive center of our hospital were chosen. 3D-HyCoSy was used to check tubal patency, and adverse reactions were recorded. 21 cases among of them underwent laparoscopic tubal cannulation hydrotubation. With the observation results as a standard,consistency of two kinds of methods in checking tubal patency were evaluated. Results Among 39 cases,3 cases of infertility patients underwent tubal resection and 75 fallopian tubes underwent 3D-HyCoSy. Results showed 37 unobstructed tubes,18 jammed tubes and 20 obstructed tubes. 42 fallopian tubes of 21 cases underwent laparoscopic tubal cannulation hydrotubation. The consistency check was conducted with the observation results as a standard. Kappa value was 0.701, and the overall coincidence rate was 85.7%（36/42）.In the process of 3D-HyCoSy inspection among 39 cases, there were 6 cases of no obvious discomfort, 32 cases of mild pain, and 1 case of obvious pain who could stand. All the cases had complete inspection, and abdominal pain was relieved after inspection without allergic reac-tions. Conclusion 3d-HyCoSy can display tubal patency clearly. It is simple with high security and has great value in clinical application in the diagnosis of infertility caused by tubal diseases.