实时三维超声输卵管造影评价未产妇药物流产次数与输卵管通畅度的关系

Relationship Between Times of Medical Abortion and Fallopian Tube Function Evaluated by Real-Time Three-Dimensional Ultrasound Salpingography

目的应用实时三维超声输卵管造影评价未产妇药物流产次数与输卵管通畅度的关系。资料与方法对2015年12月—2019年12月于青岛大学附属医院就诊的药物流产后继发性不孕患者115例(230条输卵管)行实时三维超声造影检查,诊断输卵管通畅性,并分为通畅组(n=45)、通而不畅组(n=114)、阻塞组(n=71),对通而不畅的输卵管进行评分,并分析不同药物流产次数与输卵管通畅情况、通而不畅评分、显影时间及输卵管阻塞位置的关系。结果随着未产妇药物流产次数增多,输卵管通畅率明显降低(流产次数1~4次输卵管通畅率分别为26.6%、13.5%、8.3%、0;χ^(2)=9.506,P=0.023),输卵管通而不畅评分增高[流产次数1~4次评分分别为(1.56±0.65)分、(1.90±0.68)分、(2.92±0.76)分、(4.33±0.58)分;F=28.182,P<0.001],输卵管显影时间延长[流产次数1~4次显影时间分别为(3.10±0.42)s、(5.31±0.42)s、(6.80±0.53)s、(8.27±0.40)s;F=452.117,P<0.001]。未产妇药物流产对输卵管阻塞的发生率有一定影响,流产1次与流产4次间差异显著(25.8%比62.5%;χ^(2)=5.016,P=0.025)。输卵管阻塞患者的阻塞部位多发生在峡部,随着流产次数增多,阻塞部位差异无统计学意义(χ^(2)=4.159,P=0.901)。结论流产次数越多,对输卵管功能的影响越大,实时三维超声输卵管造影可对药物流产后输卵管的功能评估和阻塞部位做出准确判断,为进一步临床治疗提供可靠依据。

Purpose To evaluate the relationship between times of medical abortion and fallopian tube function in non-parturient women via real-time three-dimensional ultrasound salpingography.Materials and Methods A total of 115 women(230 fallopian tubes)with secondary infertility in the Affiliated Hospital of Qingdao University from December 2015 to December 2019 due to medical abortion were retrospectively enrolled,and all patients were evaluated by real-time three-dimensional ultrasound salpingography to identify the patency of the fallopian tube.Based on categorical statement,all patients were further divided into three groups,including patent group(n=45),occluded group(n=71),and uncertain group(n=114).Moreover,the scores of uncertain group were cumulated.The relationship between times of medical abortion and the fallopian tube patency,the scores of the uncertain tubes,the time of imaging developing as well as the location of tubal obstruction were further analyzed.Results With more times of medical abortion in non-parturient women,the poorer performance of tubal patency(26.6%,13.5%,8.3%,0,respectively;χ^(2)=9.506,P=0.023),the higher the score of the uncertain tubes’evaluation(1.56±0.65,1.90±0.68,2.92±0.76,4.33±0.58,respectively;F=28.182,P<0.001),and the longer time in image developing[(3.10±0.42)s,(5.31±0.42)s,(6.80±0.53)s,(8.27±0.40)s,respectively;F=452.117,P<0.001]were detected.Nonparturient medical abortion had a certain effect on the incidence of tubal obstruction,and there was significant difference in tubal obstruction between women with medical abortion for once and women with four times(25.8%vs.62.5%;χ^(2)=5.016,P=0.025).Tubal obstruction mostly located in the isthmus of the tube,however,there was no significant difference in obstructive locations among patients with medical abortion(χ^(2)=4.159,P=0.901).Conclusion The more times of abortions,the greater damages on fallopian tube function.Real-time three-dimensional ultrasound salpingography can accurately assess the fallopian tube function after medical abortion,providing a reliable basis for further clinical treatment.