4D-HyCoSy联合宫腔压力测量对输卵管性不孕患者输卵管通畅性预测效能

Predictive Efficacy of 4D-HyCoSy Combined with Uterine Cavity Pressure Measurement on Tubal Patency inPatients with Tubal Infertility

目的 探讨四维子宫输卵管超声造影(4D-HyCoSy)联合宫腔压力测量对输卵管性不孕患者输卵管通畅性预测效能。方法 选取2020年2月—2022年5月收治的输卵管性不孕132例,均行4D-HyCoSy检查,并在检查期间测量宫腔压力,观察造影剂逆流状态下二者联合对输卵管通畅情况的诊断效能。结果 4D-HyCoSy对输卵管性不孕患者输卵管通畅性的诊断准确率为83.33%,出现逆流42例。造影剂逆流状态下宫腔注药压力低于无逆流状态下宫腔注药压力(P<0.01)。逆流状态下宫腔压力测量输卵管双侧阻塞、一侧阻塞或一侧通而不畅、不完全通畅、双侧通畅的曲线下面积(AUC)分别为0.759、0.564、0.509、0.980。造影剂逆流状态下4D-HyCoSy和宫腔压力测量联合检测对输卵管性不孕患者输卵管双侧阻塞诊断效能的AUC大于单一检测(P<0.01)。结论 4D-HyCoSy检查期间出现造影剂逆流状态后联合宫腔压力测量能够提高输卵管通畅度诊断率。

Objective To investigate the predictive efficacy of 4D-HyCoSy combined with uterine cavity pressure measurement on tubal patency in patients with tubal infertility.Methods A total of 132 patients with tubal infertility admitted from February 2020 to May 2022 were selected.All of them underwent 4D-HyCoSy examination,and uterine cavity pressure was measured during examination to observe the diagnostic efficacy of the combination of the two methods for tubal patency under the state of countercurrent contrast agent.Results The accuracy rate of 4D-HyCoSy diagnosis of tubal patency in tubal infertility patients was 83.33%,and 42 cases had reflux.The intrauterine injection pressure in counter-current state was lower than that in no counter-current state(P<0.01).The area under the curve(AUC)of uterine cavity pressure measurement of bilateral obstruction,unilateral obstruction,unilateral without obstruction and patency,incomplete patency and bilateral patency under the state of countercurrent contrast agent were 0.759,0.564,0.509 and 0.980,respectively.The AUC of 4D-HyCoSy combined with uterine cavity pressure measurement under the state of countercurrent contrast agent in the diagnosis of bilateral tubal obstruction in patients with tubal infertility was greater than that of single detection(P<0.01).Conclusion Combined intrauterine cavity pressure measurement under the state of countercurrent contrast agent during 4DHyCoSy examination can improve the diagnostic rate of fallopian tube patency.