宫腔声学造影联合经阴道三维超声检测对宫腔粘连患者的临床意义

Clinical significance of sonohysterography combined with transvaginal three-dimensional ultrasound for patients with intrauterine adhesion

目的探讨宫腔声学造影联合经阴道三维超声检测对宫腔粘连的临床价值,以期为临床诊治提供参考依据。方法选取2018年3月-2019年10月期间在湖州市妇幼保健院接受检查的129例疑似宫腔粘连患者为研究对象,所有入选者均接受宫腔声学造影及经阴道三维超声检查,并于上述两项检查结束3 d后接受宫腔镜检查,以宫腔镜检查结果作为金标准,分析宫腔声学造影联合经阴道三维超声检测对宫腔粘连的检出率及分度、分型的诊断结果及诊断效能。结果宫腔镜检查宫腔粘连检出率为98.45%,宫腔声学造影联合经阴道三维超声检查的检出率为96.90%,两种检查方法对比差异无统计学意义(P>0.05)。本次对127例宫腔镜检查确诊的宫腔粘连患者进行分度研究发现,宫腔声学造影联合经阴道三维超声检查与宫腔镜检查一致性较好,Kappa值为0.806。本次对127例宫腔镜检查确诊的宫腔粘连患者进行分型研究发现,宫腔声学造影联合经阴道三维超声检查与宫腔镜检查一致性较好,Kappa值为0.789。结论宫腔声学造影联合经阴道三维超声检测对宫腔粘连具有较高的诊断价值,可显著区分不同分型及分度的宫腔粘连,临床可推广使用。

Objective To explore the clinical value of sonohysterography combined with transvaginal three-dimensional ultrasound for intrauterine adhesion, provide a reference basis for clinical diagnosis and treatment. Methods A total of 129 patients with suspected intrauterine adhesion who were examined in Huzhou Municipal Maternal and Child Health Care Hospital from March 2018 to October 2019 were selected as research object, all the enrolled patients underwent sonohysterography and three-dimensional transvaginal ultrasound examination.After 3 days, hysteroscopy was performed, and the results were used as the gold standard to analyze the detection rate and grading, the diagnostic results of grading, and the diagnostic efficiency of sonohysterography combined with three-dimensional transvaginal ultrasound examination for intrauterine adhesions. Results The detection rate of hysteroscopy for intrauterine adhesion was 98.45%, and the detection rate of sonohysterography combined with transvaginal three-dimensional ultrasound was 96.90%, there was no statistically significant difference between the two methods(P>0.05). Sonohysterography combined with transvaginal three-dimensional ultrasound was in great conformity with hysteroscopy, with a Kappa value of 0.806;sonohysterography combined with transvaginal three-dimensional ultrasound was in great conformity with hysteroscopy, with a Kappa value of 0.789. Conclusion Sonohysterography combined with transvaginal three-dimensional ultrasound has high diagnostic value for intrauterine adhesion, the method can significantly distinguish different types and grades of intrauterine adhesion, which can be popularized in clinical application.