四维超声子宫输卵管造影对宫外孕保守治疗后输卵管通畅性的评估价值

Value of four-dimensional ultrasound hysterosalpingography in evaluating fallopian tube patency after conservative treatment of ectopic pregnancy

目的探究四维超声子宫输卵管造影(4D-HyCoSy)在评价宫外孕保守治疗后输卵管通畅性中的价值。方法选取2016年12月至2017年12月在我院妇产科成功进行腹腔镜保守治疗的65例宫外孕患者为研究对象。以腹腔镜下美兰通液术的诊断结果作为参照金标准,评估患者输卵管的通畅性及4D-HyCoSy的诊断能力。结果本研究65例患者共有130条输卵管。4D-HyCoSy与腹腔镜的诊断结果比较,差异无统计学意义(P>0.05)。应用4D-HyCoSy诊断宫外孕患者输卵管阻塞的灵敏度为96.47%(82/85),特异度为80.00%(36/45),阳性预测值为90.11%(82/91),阴性预测值92.31%(36/39),准确率90.77%(118/130)。治疗后,双侧通畅组患者受孕率为72.22%,单侧通畅组患者受孕率为55.56%,双侧不通组受孕率为10.53%。结论对于宫外孕保守治疗后患者,应用4D-HyCoSy技术检测的灵敏度、特异度及准确度均较高,值得临床推广。

Objective To explore the value of four-dimensional ultrasound hysterosalpingography(4D-HyCoSy) in evaluating fallopian tube patency after conservative treatment of ectopic pregnancy. Methods Sixty-five cases of ectopic pregnancy who were successfully treated by laparoscopic conservative treatment in gynecology and obstetrics department in our hospital from December 2016 to December 2017 were selected as the research objects. The diagnostic results of laparoscopic methylene blue dye liquid hydrotubation were used as reference gold standard, then the patency of fallopian tube and the diagnostic ability of 4D-HyCoSy were evaluated. Results In this study, there were 130 fallopian tubes in 65 patients. There was no significant difference in diagnosis results between 4D-HyCoSy and laparoscopy(P>0.05). 4D-HyCoSy had a sensitivity of 96.47%(82/85), a specificity of 80.00%(36/45), a positive predictive value of 90.11%(82/91), a negative predictive value of 92.31%(36/39) and a accuracy of 90.77%(118/130). After treatment, the pregnancy rate of the patients in the bilateral patency group was 72.22%, that of the unilateral patency group was 55.56%, and that of the bilateral obstruction group was 10.53%. Conclusion 4D-HyCoSy has high sensitivity, specificity and accuracy for patients with ectopic pregnancy after conservative treatment, which is worthy of clinical promotion.