超声造影评估输卵管介入再通术后输卵管通畅性的应用价值

Evaluation of the fallopian tube patency in infertile women after recanalization with hysterosalpingo contrast sonography

目的探讨超声造影评估输卵管介入再通术后输卵管通畅性的应用价值。方法 2015年1月至2016年9月在上海市普陀区中心医院行输卵管介入再通术的患者56例。其中40例患者78条输卵管输卵管介入再通术前进行了输卵管超声造影与碘油造影。56例患者106条输卵管在输卵管介入再通术前、术后即刻进行了碘油造影,其中40例患者78条输卵管在输卵管介入再通术前同时进行了输卵管超声造影。术后3个月应用超声造影评估输卵管通畅性,并计算再次阻塞率。采用χ2检验比较输卵管介入再通术前输卵管超声造影与碘油造影结果、输卵管介入再通术后即刻与术后3个月输卵管通畅性。结果输卵管介入再通术前,超声造影结果显示阻塞40条,通而不畅38条;碘油造影结果显示44条阻塞,34条通而不畅。超声造影与碘油造影结果差异无统计学意义。输卵管介入再通术前,56例患者106条输卵管中,53条通而不畅,53条阻塞。输卵管介入再通术后即刻,72条通畅,34条通而不畅,无一条输卵管阻塞。56例患者106条再通成功的输卵管,术后3个月有22条发生再次阻塞,再次阻塞率为20.7%(22/106)。输卵管介入再通术后即刻通畅的72条输卵管,输卵管介入再通术后3个月显示42条通畅,16条通而不畅,14条阻塞,再次阻塞率为19.4%(14/73);输卵管介入再通术后即刻通而不畅的34条输卵管,输卵管介入再通术后3个月显示26条通而不畅,8条阻塞,再次阻塞率为23.5%(8/34)。输卵管介入再通术后3个月,输卵管介入再通术后即刻通畅的输卵管再次阻塞率与通而不畅的输卵管再次阻塞率差异无统计学意义。结论输卵管介入再通术3个月后部分输卵管会发生再次阻塞,输卵管超声造影可为输卵管介入再通术后指导备孕提供客观有效的依据。

Objective To evaluate the value of hysterosalpingo-contrast-sonography in assessment the patency of fallopian tube after tubal interventional recanalization. Methods A total of 56 cases of fallopian tube recanalization were performed in Shanghai Putuo Hospital from January 2015 to September 2016. Seventy-eight fallopian tubes in 40 cases were treated with hysterosalpingo-contrast-sonography and hysterosalpingography before recanalization. Totally 106 fallopian tubes in 56 cases were performed hysterosalpingography before and after recanalization. Seventy-eight fallopian tubes in 40 cases were evaluated with hysterosalpingo-contrast-sonography before recanalization. The patency of the tubal was assessed by hysterosalpingo-contrast-sonography 3 months after recanalization, and the re-occlusion rate was calculated. Chi square test was used to compare the results of hysterosalpingo-contrast-sonography and hysterosalpingography before and after recanalization, and the patency of fallopian tube at just after operation and 3 months after recanalization. Results Before recanalization, the results of hysterosalpingocontrast-sonography showed 40 obstructed and 38 partially obstructed. The results of hysterosalpingography showed 44 obstructed and 34 partially obstructed. There was no significant difference between the results of hysterosalpingo-contrast-sonography and hysterosalpingography. Before recanalization, 106 fallopian tubes in 56 cases showed 53 obstructed and 53 partially obstructed. After recanalization, 72 unobstructed, 34 partially obstructed, and no obstruction. However, 22 fallopian tubes were re-obstructed 3 months after recanalization, and the rate of re-occlusion was 20.7%（22/106）. The re-occlusion rate of unobstructed fallopian tubes was 19.4%（14/73） and the re-occlusion rate of partially obstructed fallopian tubes was 23.5%（8/34）. There was no statistically significant difference between them. Conclusions Re-obstruction may be present in some cases 3 months after tubal recanalization. Hysterosalpingo-contrast-sonography can provide an objective and effective basis for guiding pregnancy plan after tubal recanalization.