經(jīng)陰道子宮輸卵管超聲造影技術(shù)評價輸卵管通暢性

余秋　秦敏

【摘要】 目的：探討經(jīng)陰道子宮輸卵管超聲造影技術(shù)評價輸卵管通暢性的應(yīng)用價值。方法：選取2016年9月-2017年9月筆者所在醫(yī)院收治的需要進行腹腔鏡探查的不孕癥患者，共35例，所有患者術(shù)前行經(jīng)陰道子宮輸卵管超聲造影，共68條輸卵管，評估后行腹腔鏡探查術(shù)+輸卵管通液術(shù)。結(jié)果：35例共68條輸卵管，經(jīng)陰道子宮輸卵管超聲造影顯示66條（97.06%），兩種診斷方法差異無統(tǒng)計學(xué)意義（字2=0.12，P=0.73）。68條輸卵管中，21條阻塞（30.88%），28條通暢（41.18%），19條通而不暢（27.94%），包括一側(cè)通而不暢7例，兩側(cè)均通而不暢6例；68條輸卵管中，12條輸卵管傘端粘連（17.65%）。同時，與金標準腹腔鏡下輸卵管狀況結(jié)合亞甲藍通液術(shù)比較，經(jīng)陰道子宮輸卵管超聲造影診斷輸卵管梗阻的敏感性為87.5%（35/40），特異性為89.29%（25/28），陽性預(yù)測率為92.11%（35/38），陰性預(yù)測率為83.33%（25/30）。所有腹腔鏡患者均接受不同程度粘連松解等手術(shù)治療，術(shù)后隨訪6～12個月，35例患者有22例受孕，受孕率62.86%。結(jié)論：經(jīng)陰道子宮輸卵管超聲造影技術(shù)可以直觀、清晰顯示輸卵管通暢情況及輸卵管全貌，以及明確輸卵管梗阻的部位及范圍，是一種行之有效的檢測手段。

【關(guān)鍵詞】 經(jīng)陰道子宮輸卵管超聲； 造影； 不孕癥； 輸卵管

doi：10.14033/j.cnki.cfmr.2018.12.033 文獻標識碼 B 文章編號 1674-6805（2018）12-0073-02

Transvaginal Uterine Tubal Ultrasonic Imaging Technology Evaluation of Tubal Patency/YU Qiu，QIN Min.//Chinese and Foreign Medical Research，2018，16（12）：73-74

【Abstract】 Objective：To investigate the application value of transvaginal uterine tubal ultrasonic imaging technology for the diagnosis of tubal patency.Method：From September 2016 to September 2017 a total of 35 cases of infertility patients treated in our hospital in the need for laparoscopic exploration were selected.All patients before surgery did transvaginal uterine tubal contrast-enhanced ultrasound，68 of the fallopian tubes，assessment after laparoscopic surgical exploration and oviduct through liquid.Result：There were 68 fallopian tubes in 35 cases and 66（97.06%） in the transvaginal hysterectomy.Of the 68 fallopian tubes，21 blocked（30.88%），28 unobstructed（41.18%），19 pass-through（27.94%），including a unilateral and unsmooth 7 cases，with both sides not free of 6 cases.Of the 68 fallopian tubes，12 tubes of fallopian tubes had adhesion （17.65%）.At the same time，with the gold standard of laparoscopic tubal conditions combined with methylene blue fluid technique comparison，two methods of diagnosis there was no statistically significant difference（字2=0.12，P=0.12），transvaginal ultrasonic imaging in the diagnosis of tubal uterine tubal obstruction sensitivity was 87.5%（35/40），specificity of 89.29%（25/28），the positive predictive rate was 92.11% （35/38），when negative rate was 83.33%（25/30）.All laparoscopic patients underwent surgical treatment with varying degrees of adhesion and dissolving，followed by 6 to 12 months postoperative follow-up，and 22 pregnancies in 35 patients（62.86%）.Conclusion：Transvaginal uterine tubal ultrasound imaging technology can be intuitive，clearly display tubal patency and tubal，and specify the location and scope of the fallopian tube obstruction，it is an effective means of detection.