经阴道子宫输卵管四维超声诊断输卵管通畅性

Clinical value of vagina uterine tubal four-dimensional B-ultrasound in the diagnosis of tubal patency

目的探讨经阴道子宫输卵管四维超声诊断输卵管通畅性的临床价值。方法随机选取2016年5月至2017年12月临床资料完整的不孕症女性患者208例,均经输卵管造影确诊,且符合卵泡不成熟性不育的诊断标准。208例中经腹部多普勒超声检查63例,经阴道子宫输卵管四维超声检查78例,经腹与经阴道超声联合检查67例。回顾性分析208例不孕患者的临床资料,比较经腹与经阴道超声诊断准确率及不良反应。结果腹部超声诊断准确率为92. 06%(58/63),阴道子宫输卵管四维超声准确率为97. 44%(76/78),经腹与经阴道超声联合准确率为98. 51%(66/67),超声联合与腹部超声诊断准确率比较,差异有统计学意义(P <0. 05)。腹部超声正确诊断58例中,发现不良反应15例(25. 86%);经阴道超声正确诊断76例中,发生不良反应21例(27. 63%),两组轻度、中重度不良反应比较,差异未见统计学意义(P>0. 05)。结论经阴道子宫输卵管四维超声能立体显示输卵管走行方向和扭曲程度,其不良反应与腹部超声比较未见明显增加,可依据患者病情联合应用经腹和经阴道超声诊断女性早期不孕症,以提高诊断准确性,减少漏诊和误诊。

Objective To investigate the clinical value of vagina uterine tubal four-dimensional B-ultrasound in the diagnosis of tubal patency. Methods A total of 208 female patients with complete clinical data from May 2016 to December 2017 were randomly selected, and all of them were diagnosed by oviduct radiography and were in line with the diagnostic criteria for infertility. Among the 208 patients, there wore 63 patients treated by the transabdominal Doppler sonography, 78 patients treated by vagina uterine tubal four-dimensional B-ultrasound, and 67 patients examined by transabdominal and transvaginal ultrasouiad. The clinical data of 208 infertile patients were retrospectively analyzed, and the accuracy and adverse reactions were compared between abdominal and transvaginal ultrasound. Results The accuracy of abdominal ultrasound diagnosis was 92. 06% （58/63）, and the accuracy rate of four dimensional ultrasound of vaginal uterine tube was 97. 44% （76/78）. The accuracy rate of combined transabdominal and transvaginal ultrasound was 98.51% （66/67）, and the differences were significant compared with abdominal ultrasound （P 〈0. 05）. Among the 58 cases with abdominal ultrasonic diagnosis, there were 15 cases （25. 86% ） had adverse reactions; among the 76 cases diagnosed correctly by transvaginal ultrasound, there were 21 cases （27.63%） had adverse reactions. The difference in mild and moderate severe adverse reactions between the two groups was not significant （P 〉 0. 05 ）. Conclusions Four- dimensional ultrasound of vaginal uterine tube can display the direction of the fallopian tube and the degree of distortion. The adverse reaction and the abdominal ultrasound have not been significantly increased. The diagnosis of early infertility can be improved by the combination of the abdominal and transvaginal ultrasound in order to improve the accuracy of diagnosis and reduce misdiagnosis and misdiagnosis.