经阴道子宫输卵管四维超声造影诊断不孕症的临床价值

Clinical Value of TVS 4D-Hycosy in the Diagnosis of Infertility

目的:探讨经阴道子宫输卵管四维超声造影(transvaginal four-dimensional hysterosalpingo-contrast sonography,TVS 4D-Hycosy)诊断不孕症的临床价值。方法:收集2018年1月至2018年12月在大理大学第一附属医院就诊的不孕症患者324例,均行TVS 4D-Hycosy,观察输卵管的通畅性及宫腔的病变情况。结果:324例患者中输卵管双侧通畅125例,双侧堵塞46例,单侧堵塞127例,单侧或双侧通而不畅26例;发现子宫内膜息肉11例,宫腔黏连5例,黏膜下肌瘤1例;输卵管积液6例,宫颈黏连6例,子宫畸形2例,造影剂子宫肌层逆流37例。随访半年内怀孕93例。结论:TVS 4D-Hycosy能够实时动态地判断输卵管通畅性及宫腔病变情况,且具有准确性高、操作简单、无创、无辐射、不良反应小、可重复性强等优点,同时具备诊断和治疗的双重作用,是一种检查输卵管通畅性及宫腔病变的有效方法,值得临床上广泛应用。

Objective:To explore the clinical value of transvaginal four-dimensional hysterosalpingo-contrast sonography(TVS 4DHycosy)in the diagnosis of infertility.Methods:324 cases were diagnosed with infertility in the First Affiliated Hospital of Dali University from January 2018 to December 2018,and TVS 4D-hycosy was adopted to observe the patency of fallopian tube and uterine cavity lesions.Results:Among the 324 patients,there were 125 cases of bilateral oviduct patency,46 cases of bilateral obstruction,127 cases of unilateral obstruction,26 cases of unilateral or bilateral partially obstruction,11 cases of endometrial polyps,5 cases of intrauterine adhesion,1 case of submucosal fibroids;6 cases of fallopian tube hydrops,6 cases of cervical adhesion,2 cases of uterine deformity,and 37 cases with contrast agent myometrial countercurrent.93 cases were pregnant within 6 months of follow-up.Conclusion:TVS 4D-Hycosy is capable of real-time dynamic judgment tubal patency and uterine cavity lesions,and it has the advantages of high accuracy,simple operation,noninvasive,no radiation,less adverse reaction,and strong repeatability,etc.At the same time,it has the dual role of diagnosis and treatment,therefore it is a kind of examination of uterine cavity lesions of tubal patency and effective method which is worthy of being widely used clinically.