实时三维子宫输卵管超声造影在输卵管源性不孕症中的临床应用

Diagnostic value of transvaginal real time three-dimensional hysterosalpingo-contrast sonography in tubal infertility

目的探讨经阴道实时三维子宫输卵管超声造影(RT-3D-HyCoSy)在输卵管源性不孕症中的临床应用价值。方法选取2017年8月至2018年7月在桂林医学院附属医院考虑为输卵管源性不孕症患者469例为研究对象,将患者随机分为观察组239例(RT-3D-HyCoSy)及对照组230例[子宫输卵管X线造影(HSG)],对比观察2组输卵管走形及盆腔造影剂分布情况,判断输卵管通畅性。结果RT-3D-HyCoSy显示双侧输卵管通畅179例(74.9%),双侧输卵管阻塞19例(7.9%),一侧输卵管阻塞41例(17.2%),HSG显示双侧输卵管通畅159例(69.1%),双侧输卵管阻塞27例(11.7%),一侧输卵管阻塞44例(19.1%),显示2种检查方法比较差异无统计学意义(P>0.05),且RT-3D-HyCoSy可清晰显示宫腔病变34例,其中,子宫内膜息肉16例,子宫畸形3例,子宫黏膜下肌瘤3例,宫腔粘连12例。结论RT-3D-HyCoSy可动态立体显示子宫输卵管情况、无辐射、无碘过敏等优点,在诊断输卵管源性不孕症中操作便捷、安全、准确,值得临床推广。

Objective To investigate the clinical application of transvaginal real time three-dimensional hysterosalpingo-contrast sonography(RT-3D-HyCoSy)in tubal infertility.Methods A total of 469 tubal infertile patients were recruited in the Affiliated Hospital of Guilin Medical University from August 2017 to July 2018.The patients were random divided into two groups,the observation group(RT-3D-HyCoSy)had 239 Cases,the control group(HSG)had 230 cases,detection the contrast agent flowing in fallopian tubes and pelvic cavity,two methods of evaluating tubal patency were compared.Results RT-3D-HyCoSy examination showed that the bilateral patency was 179 cases(74.9%),and bilateral obstruction was 19 cases(7.9%),monolateral obstruction was 41 cases(17.2%).HSG examination showed that the bilateral patency was 159 cases(69.1%),and bilateral obstruction was 27 cases(11.7%),monolateral obstruction was 44 Cases(19.1%).There was no significant difference between the two detection methods(P>0.05).And RT-3D-HyCoSy showed 16 cases with intrauterine polyps,3 cases with uterine anomaly,3 Cases with myoma,12 case with intrauterine adhesions.Conclusion RT-3D-HyCoSy has the advantage of real-time、dynamic,with no risk of allergic reactions to the contrast medium and with no patient exposure to radiationis,which make it a good way for evaluating fallopian tubal patency.And it is worthy of application in clinic work.