子宫输卵管超声造影对受检不孕症患者疼痛的影响因素

Influencing factors of hysterosalpingo-contrast sonography on pain degree of infertility women

目的:比较四维子宫输卵管超声造影(4D-HyCoSy)与X线子宫输卵管造影(X-HSG)对受检患者疼痛程度差异,分析4D-HyCoSy疼痛的影响因素。方法:选取2014年3月-2018年12月本院行子宫输卵管造影检查患者190例,按照随机数字原则分为X-HSG组及4D-HyCoSy组,比较两组NRS疼痛评分及Stacey分级,分析4D-HyCoSy检查对患者疼痛的影响因素。结果:4D-HyCoSy组NRS疼痛评分(4.7±1.4分)高于X-HSG组(4.2±1.5分),2级疼痛比例(51.6%)高于X-HSG组(39.0%)(P<0.05);4D-HyCoSy检查,NRS评分>5分者造影时间、置管时间、单侧阻塞及双侧阻塞比例、置管深度/内膜线长度、球囊注水量均大于≤4分者(P<0.05),患者年龄、不孕时间、体质指数、分娩史、痛经、盆腔炎史、子宫位置比例等≤4分与>5分者比较无差异(P>0.05);造影时间、单侧阻塞、双侧阻塞、球囊注水量是4D-HyCoSy检查NRS评分>5分的独立危险因素(P<0.05)。结论:4D-HyCoSy的疼痛程度较X-HSG略重,造影时间较长、输卵管单侧或双侧阻塞及球囊注水量较大是4D-HyCoSy检查患者疼痛的危险因素。

Objective:To compare the difference of 4-dimensional hysterosalpingo-contrast sonography(4D-HyCoSy)and X-ray hysterosalpingography(X-HSG)on the pain degree of infertility women.Methods:190 infertility women who wanted hysterosalpingo-contrast examination were selected as study objects from March 2014 to December 2018.According to the principle of random numbers,these women were divided into X-HSG group and 4D-HyCoSy group.The scores of NRS pain and Stacey scales of women were compared between two groups,and the influencing factors of 4D-HyCoSy on the pain degree of infertility women were analyzed.Results:The NRS pain score and the proportion of pain grade 2 of women in 4D-HyCoSy group were 4.7±1.4 points and 51.6%,which were significant higher than those(4.2±1.5 and 39.0%)of women in X-HSG group(P<0.05).In 4D-HyCoSy group,time of contrast imaging,catheterization time,proportion of unilateral and bilateral obstruction,catheterization depth/intimal line length,and balloon infusion volume of women with score of NRS>5 points were significant more than those of women with score of NRS≤4 points(P<0.05).There were no statistical difference in age,infertility time,BMI,rates of history of delivery,dysmenorrheal and history of pelvic inflammatory disease,and proportion of uterine with different position between women with score of NRS>5 points and women with score of NRS≤4 points(P>0.05).The contrast imaging time,unilateral obstruction,bilateral obstruction,and balloon infusion volume were independent risk factors for NRS score>5 points(P<0.05).Conclusion:The pain degree of women undergone 4D-HyCoSy is slightly heavier than that of women undergone X-HSG.The longer contrast imaging time,the higher rate of unilateral or bilateral obstruction of fallopian tube,and larger balloon injection volume are the risk factors of pain of women undergone 4D-HyCoSy.