实时三维子宫输卵管超声造影耐受性和安全性评估

Pain associated with 3-dimensional transvaginal hysterosalpingo-contrast sonography

目的:评估经阴道实时三维子宫输卵管超声造影(3D Hy Co Sy)的耐受性以及与造影相关疼痛的预测因素。方法:160例不育症患者进行子宫输卵管超声造影后,用视觉模拟评分法(VAS)对患者两个不同时间点(T1,Hy Co Sy结束时;T2,Hy Co Sy结束后30 min)进行疼痛程度评估,同时记录患者有无发烧、盆腔感染、腹膜炎和出血等。结果:155例(96.9%)患者完成子宫输卵管超声造影检查,其中139例(89.7%)患者经历了疼痛,3例(1.94%)患者经历了轻度血管迷走神经反应。Hy Co Sy检查结束30 min后,仅2.58%(4/155)的患者仍感到不适。在评估的各影响因素中,输卵管通畅情况与Hy Co Sy疼痛显著相关,年龄、月经周期、不育的持续时间和孕次与Hy Co Sy疼痛无显著的相关性。结论:3D Hy Co Sy检查耐受性好、价格低廉、流程短,值得在临床实践中广泛应用。

Objective： To assess the pain and adverse effects incurred by women undergoing Transvaginal 3-dimensional hysterosalpingo-contrast sonography（ 3D Hy Co Sy）. Methods： 160 consecutive women as part of infertility evaluation were included. The predictive factors of pain were assessed simultaneously. The pain experienced was then evaluated by visual analogue scale（ VAS）. Each patient was asked to rate her pain at two different points of time（ T1,immediately after Hy Co Sy; T2,30 min after Hy Co Sy）. Through evaluating the pelvic pain immediately after Hy Co Sy and 30 min after Hy Co Sy,the pain decrease was also observed. Whether patients with fever,pelvic infections,peritonitis,bleeding were also recorded. Results： 155 patients（ 96. 9%） completed the procedure. Pain was experienced by 139 of subjects（ 89. 7%） and 3 cases（ 1. 94%） experienced mild vasovagal reactions. 30 min after Hy Co Sy procedure,only 2. 58%（ 4 /155） patients felt severe pelvic pain. Women with tubal obstruction experienced a significant increase in 3D Hy Co Sy-associated pain. Conclusion： 3D Hy Co Sy is a well-tolerated examination with a very low rate of side effects and it is worthy to be widely used in clinical practice.