经阴道四维子宫输卵管超声造影(4D-HyCoSy)在诊断输卵管通畅性中的应用和临床价值探讨

Application of Transvaginal Four-dimensional Hysterosalpingography(4D HyCoSy) in the Diagnosis of Tubal Patency and its Clinical Value

目的:探讨不孕不育患者接受经阴道四维子宫输卵管超声造影(4D-HyCoSy)对其输卵管通畅性的诊断效果及临床价值。方法:将2019年3月至2020年5月期间因不孕症来院治疗的108例女性患者纳为研究对象。患者均行经阴道四维子宫输卵管超声造影检查,以回顾性分析的方式针对检查结果、不良反应和随访结果展开统计与研究。结果:电话随访108名患者,获得随访87例,失访21例,失访率为19.4%(21/108)。院超声造影检查结果显示,双侧输卵管通畅患者占比为14.81%(16/108);双侧输卵管堵塞患者占比为11.11%(12/108);单侧输卵管阻塞患者占比为22.22%(24/108);双侧输卵管通而不畅患者占比为14.81%(16/108);一侧通畅一侧通而不畅患者占比为29.63%(32/108);宫外孕一侧切除患者占比为7.41%(8/108);仅有17例轻微疼痛感受的患者,其他均未见严重不良反应;87例获得随访的患者结果显示,共有31例患者顺利怀孕,占比35.6%(31/87),其中28例为自然怀孕,3例行试管婴儿。结论:通过将经阴道四维子宫输卵管超声造影(4D-HyCoSy)检查方法应用在不孕不育患者临床诊治中,能够对其输卵管通畅性做出科学评估,对提升诊断及治疗效果具有诸多积极作用,因此适合普及推广使用。

Objective:To investigate the diagnostic effect and clinical value of transvaginal fourdimensional hysterosalpingography(4D HyCoSy)on tubal patency in infertile patients.Methods:108 female patients who came to the hospital for treatment due to infertility from March 2019 to may 2020were included as the research object.All patients underwent transvaginal four-dimensional hysterosalpingography,and the results of examination,adverse reactions and follow-up were analyzed retrospectively.Results:108 patients were followed up by telephone,87 cases were followed up and 21 cases were lost,The lost follow-up rate was 19.4%(21/108).In the hospital,the results of contrast-enhanced ultrasonography showed that the proportion of patients with bilateral tubal patency was 14.81%(16/108),the proportion of patients with bilateral tubal obstruction was 11.11%(12/108),the proportion of patients with unilateral tubal obstruction was 22.22%(24/108),and the proportion of patients with bilateral tubal patency was 14.81%(16/108);29.63%(32/108)of the patients had one side unobstructed and one side unobstructed;7.41%(8/108)of the patients had one side resection of ectopic pregnancy;there were only 17 patients with mild pain,and no other serious adverse reactions;the results of 87patients who were followed up showed that 31 patients had successful pregnancy,accounting for 35.6%(31/87),including 28 cases of natural pregnancy and 3 cases of ivf.Conclusion:the application of transvaginal four-dimensional hysterosalpingography(4D hycosy)in the clinical diagnosis and treatment of infertile patients can scientifically evaluate the patency of fallopian tubes and play a positive role in improving the diagnosis and treatment effect.Therefore,it is suitable for general use.