【摘要】 目的探讨经阴道四维子宫输卵管超声造影动态观察输卵管通液术的疗效。方法选取江门市人民医院收治的32例不孕症患者作为此次的临床研究对象,共输卵管64条,研究时间自2017年4月—2018年9月,所有临床诊断为输卵管源性不孕患者均采用经阴道四维子宫输卵管超声造影(4D-HyCoSy)和X线子宫输卵管造影(X-HSG),观察其输卵管通畅情况,并与X-HSG结果进行对比。给予输卵管不通畅或通而不畅的患者进行输卵管通液治疗,治疗结束后患者再次进行4DHyCoSy,观察通液治疗后输卵管是否恢复通畅。评估患者在4D-HyCoSy下接受输卵管通液术治疗后的输卵管复通率及成功妊娠率。结果 32例不孕症患者行4D-HyCoSy检查64条输卵管。以X-HSG为标准,治疗前超声造影评价输卵管通畅的符合率为100.00%(4/4),通而不畅的符合率为95.74%(45/47),积水的符合率80.00%(8/10),阻塞的符合率为100.00%(5/5),总体符合率为94.44%。4D-HyCoSy检查与X-HSG诊断输卵管通畅性的准确性差异无统计学意义(P>0.05)。在4D-HyCoSy时,32例患者中发生轻微恶心1例(3.12%),疼痛明显1例(3.12%),不良反应发生率为6.25%(2/32)。随访半年后,32例患者中妊娠成功25例,失败7例,妊娠成功率为78.12%。经输卵管通液术治疗后,共有27例患者52条输卵管实现复通(其中两例患者一侧通畅,一侧通而不畅),复通率为81.25%(52/64)。治疗后患者的输卵管通畅率明显高于治疗前,差异有统计学意义(P<0.05)。结论经阴道4D-HyCoSy动态观察输卵管通液术疗效可靠,复通率及妊娠率高,不良反应少,安全性高,具有较高的应用价值,值得临床借鉴和推广。更多还原

【Abstract】 Objective To investigate the curative effect of transvaginal four-dimensional hysterectomy of uterine fallopian tube.Methods 32 cases of infertility admitted to the hospital from April,2017 to September,2018 were included as clinical research subjects,including a total of 64 fallopian tubes. Tubal infertility of all patients clinically diagnosed as tubal infertility received vaginal four-dimensional hysterectomy(4 D-HyCoSy)and X-ray hysterectomy(X-HSG)were observed and were compared with the X-HSG results. Patients with loose or loose fallopian tubes were treated with tubal fluid. After the treatment,the patients were treated with 4 DHyCoSy to observe whether the fallopian tube was restored after the treatment. The rate of fallopian tubal relapse and successful pregnancy rate of patients treated with tubal catheterization under 4 D-HyCoSy were evaluated. Results 32 infertile patients were examined with 4 D HyCoSy,including 64 fallopian tubes. Through using the X-HSG as the standard,the compliance rate for pre-treatment ultrasound evaluation of fallopian tube patency was 100.00%(4/4),and the compliance rate for smooth and poor was 95.74%(45/47).The compliance rate for water accumulation was 80.00%(8/10),the compliance rate for obstruction was 100.00%(5/5),and the overall compliance rate was 94.44%. There was no significant difference between the accuracy of 4 D-HyCoSy test and X-HSG diagnosis of fallopian tube patency(P>0.05). At 4 D-HyCoSy,1 case had mild nausea(3.12%),1 case had pain(3.12%),and 6.25% had adverse reactions(2/32). After six months of follow-up,pregnancy was successful in 25 of the 32 cases,and failed in 7 cases. The pregnancy success rate was 78.12%. After treatment with tubal fluid surgery,a total of 27 patients had 52 fallopian tubes(of which two patients had a smooth side and one side was not smooth),and the recovery rate was 81.25%(52/64). After treatment,the tubal patency rate was significantly higher than before treatment(P<0.05). Conclusion The dynamic observation of the transvaginal four-dimensional hysterectomy is reliable. The rate of recovery and pregnancy is high. The adverse reaction is low,the safety is high,and it has high application value,which is worthy of clinical reference and promotion.更多还原