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投稿时间：2020-03-25 网络发布日期：2020-11-20
投稿时间：2020-03-25 网络发布日期：2020-11-20
中文摘要: 目的 探讨子宫输卵管四维超声造影(4D-HyCoSy)下加压脉冲推注造影剂疏通治疗临床可疑输卵管源性不孕症的作用及其在备孕一站式诊疗中的应用价值。方法 回顾性分析2017年1月至2018年7月365例接受4D-HyCoSy患者的术前病史、术中诊治情况及术后随访结果,根据术中推注造影剂的方式不同分为未疏通组(仅在4D-HyCoSy下低压缓慢匀速推注造影剂,83例)和疏通治疗组(4D-HyCoSy下低压缓慢匀速推注+加压脉冲式推注法疏通治疗,282例);当造影中发现宫腔粘连带时行球囊扩张法治疗;对单侧输卵管优势患者行卵泡监测指导择优侧备孕;将未疏通组与疏通治疗组输卵管通畅性情况和1年自然受孕率进行比较。结果 疏通治疗组疏通治疗后完全有效疏通率为66.8%,疏通有效率为76.2%。疏通治疗组1年自然受孕率高于未疏通组,差异有统计学意义(58.9% vs 38.6%,χ2=8.504,P=0.004)。当结合术中及术后进行超声卵泡监测指导备孕时,疏通治疗组疏通后1年自然受孕率明显高于未疏通组,差异有统计学意义(87.3% vs 48.1%,χ2=19.728,P=0.000)。所有患者总受孕率为54.2%。 结论 4D-HyCoSy下加压脉冲推注造影剂对不通畅输卵管进行疏通治疗的方法相较于常规传统治疗方法具有效果明显、操作简单、安全损伤小、费用低、可重复性强、当月即可备孕等优势,同时结合卵泡监测指导优侧输卵管备孕、球囊扩张法治疗宫腔粘连,更有助于备孕一站式诊疗的成功。
中文关键词: 子宫输卵管四维超声造影 不孕症 疏通治疗 备孕一站式诊疗
Abstract:Objective To investigate the effect of pressure injection of contrast agent under 4D hysterosalpingo-contrast sonography (4D-HyCoSy) in dredging therapy of suspected tubal infertility and its application value in one-stop diagnosis and preparation for pregnancy.Methods A retrospective analysis was performed on the preoperative history,diagnosis and treatment and follow-up results of 365 patients who received 4D-HyCoSy from January 2017 to July 2018.According to the different methods of intraoperative injection of contrast agent,they were divided into diagnosis group (injected slowly and uniformly under low pressure, n=83) and dredging therapy group (injected slowly and uniformly under low pressure plus pressure-pulse injection, n=282).Balloon dilation was used to treat intrauterine adhesions during 4D-HyCoSy.Follicular monitoring was performed in the patients with unilateral fallopian tube dominance to guide pregnancy preparation on the preferred side.The tubal patency and 1-year natural pregnancy rate were compared between two groups.Results In dredging therapy group,the total fallopian tube patency rate was 66.8%,and the effective rate (including complete and partial unblocking) was 76.2%;one-year natural pregnancy rate was significantly higher than that in diagnosis group (58.9% vs 38.6%, χ2=8.504, P=0.004) .With ultrasound monitoring of follicular for guiding pregnancy preparation,1-year natural pregnancy rate in dredging therapy group was significantly higher than that in diagnosis group (87.3% vs 48.1%, χ2=19.728, P=0.000).The total pregnancy rate was 54.2% in two groups.Conclusions Compared with the conventional treatment,dredging therapy with pressure pulse injection of contrast agent under 4D-HyCoSy has obvious effect for tubal-derived infertility and advantages in simple operation,small safety damage,low cost,high repeatability and ready for pregnancy preparation in the month of treatment.With follicular monitoring and balloon dilatation treatment for intrauterine adhesions,it is more conducive to the success of one stop diagnosis and treatment for pregnancy preparation.
keywords: 4D hysterosalpingo-contrast sonography Female infertility Dredging therapy One-stop diagnosis and treatment for pregnancy preparation
文章编号： 中图分类号： 文献标志码：B
基金项目:山东省济宁市科技助推新旧动能转换计划基金(2017SMNS014)
| Author Name | Affiliation |
| YAN Fen,CHEN Xiao-mei,CHEN Deng-hui,WEI Qian-qian,LI Hui-qing,CHEN Hui-li,MENG Xiang-fang | Department of Ultrasound,Qufu People′s Hospital,Jining,Shandong 273100,China |
引用文本：
颜芬, 陈晓玫, 陈登辉, 魏乾乾, 李慧清, 陈慧丽, 孟祥芳.子宫输卵管四维超声造影下加压脉冲推注造影剂治疗不孕症的效果[J].中国临床研究,2020,33(11):1552-1556.
颜芬, 陈晓玫, 陈登辉, 魏乾乾, 李慧清, 陈慧丽, 孟祥芳.子宫输卵管四维超声造影下加压脉冲推注造影剂治疗不孕症的效果[J].中国临床研究,2020,33(11):1552-1556.