超声造影术在输卵管疾病中的诊断价值

Diagnostic Value of Hysterosalpingocontrast Sonography in Uterotubal Diseases

目的探讨超声造影术在输卵管疾病中的诊断价值。方法对可疑为输卵管原因性不孕症患者40例及输卵管异位妊娠行保守药物治疗后患者36例行子宫输卵管超声造影术(HyCoSy)检查,1周后再行X线碘油造影术(HSG)检查,比较两种检查方法的结果及不良反应发生情况。结果 Hy Co Sy在清晰度方面虽不如HSG,但HyCoSy可更直观、多角度的反应输卵管的形态及走行。在不孕症患者输卵管通畅情况检查中,两种方法结果比较,差异无统计学意义(P=0.800);在输卵管异位妊娠术后患者的输卵管通畅情况检查中,两种方法的检查结果的差异亦无统计学意义(P=0.894)。两种方法检查总不良反应发生率比较,经典HSG组(31.5%)明显要高于HyCoSy组(18.4%),差异有统计学意义(P=0.012)。结论 HyCoSy作为一种宫腔输卵管造影方法,其操作安全、简便,检查结果与经典的HSG差异无统计学意义,可直观的观察输卵管的形态、走行,术后不良反应较轻微,可作为临床输卵管通畅情况评价的一种新型、准确、安全的诊断方法,具有较广泛的应用前景。

Objective To explore the diagnostic value for uterotubal diseases by using sonohysterography. Methods Forty patients with tubal infertility and 36 patients with tubal ectopic pregnancy after conservative therapy were involved. At first, they were scanned by hysterosalpingocontrast sonography （HyCoSy）. One week later, they were scanned by hysterosalpinography （HSG）. Then, the results of the two methods were evaluated and compared. Results The images of HyCoSy group were not as clear as that of the HSG group, but it could intuitively observe the shape and the flowing direction of fallopian tube. In patients with tubal infertility, there were no statistical differences between the results of the two methods （P=0.800）. No statistical differences were found between the results of the two methods（P=0.894）in patients with tubal ectopic pregnancy after conservative surgery. The total incidence of adverse reactions in HSG group （31.5%） was much higher than that of the HyCoSy group （18.4%）, and the difference was statistically significant （P=0.012）. Conclusion HyCoSy is a safe, convenient diagnostic method for the uterotubal diseases. There is no difference in evaluating the condition of fallopian tube between the classic HSG method and the HyCoSy method, but the HyCoSy method can be more intuitive in observing the shape, flowing direction of fallopian tube. Besides, its postoperative adverse reaction is mild. The HyCoSy can be used as a new and safe clinical diagnostic method for the uterotubal diseases, and has extensive prospect in many fields.