经阴道实时三维超声成像对输卵管源性不孕症的诊断研究

摘要

目的：观察经阴道实时三维超声成像对输卵管源性不孕症的诊断价值。方法应用经阴道实时三维超声成像（3D-HyCoSy）对我院30例不孕患者（59条输卵管）进行检查，诊断输卵管的通畅性和盆腔黏连情况，并以腹腔镜通液术（LSC）的检查结果作比较，评价3D-HyCoSy对输卵管源性不孕症的诊断价值。结果3D-HyCoSy检查输卵管通畅性的结果与LSC检查结果比较，诊断符合率为91．7％，具有较好的一致性（Kappa值＝0．716，P＜0．05）。30例患者3D-HyCoSy检查出疑似盆腔粘连5例，而LSC则检查出24例，检出率仅为20．8％。术中1例患者出现恶心、呕吐症状，3例腹痛、腹胀明显，其余患者无或仅轻微胀痛，检查完成后均自行缓解。结论3 D-HyCoSy可清晰、直观、全面地显示输卵管的空间走形，安全、简便、易行，在诊断输卵管通畅性方面具有一定的价值。%Objective To observe the diagnostic value of transvaginal three-dimensional real-time ultrasound imaging of tubal infertility . Methods Application of transvaginal three-dimensional real-time ultrasound imaging (3D-HyCoSy) in our hospital, 30 cases of infertility patients (59 fallopian tubes) for examination, diagnosis of fallopian tube patency and pelvic adhesions , and laparoscopy hydrotubation ( LSC) to compare the examination results , and evaluate the value of 3D-HyCoSy for diagnosis of tubal infertility .Results Comparison of 3D-HyCoSy to check the fallopian tube patency results with the results of LSC examination , the diagnostic accordance rate was 91.7%, with good consistency ( Kappa =0.716, P <0.05 ).3D-HyCoSy examination of 30 patients suspected of pelvic adhesion in 5 cases, and the LSC check out the 24cases, the detection rate of only 20.8%.During the operation 1 patients had symptoms of nausea and vomiting , abdominal pain, abdominal distension was 3 cases, the rest of patients with no or only mild pain , after the completion of the examination were relieved.Conclusions 3D-HyCoSy can clearly, intuitively, comprehensively display space shape of the fallopian tube , safe, simple, easy to operate, in the diagnosis of fallopian tube patency aspect has certain value .