| 摘要: |
| 目的 应用四维输卵管超声造影(4D-HyCoSy)对输卵管妊娠治疗后输卵管成像,评估患侧输卵管通畅性,为临床治疗提供了依据。方法 将135例输卵管妊娠治疗后患者依据输卵管妊娠治疗方法不同进行分组,药物保守治疗组(40例),腹腔镜输卵管切开取胚术组(38例)、腹腔镜部分输卵管切除吻合术组(25例)及腹腔镜下输卵管切除术组(32例),利用阴道四维超声造影观察各组间输卵管通畅性并进行对比。结果 药物保守治疗组患侧输卵管通畅4条(10.0%),通而不畅20条(50.0%),阻塞16条(40.0%)；腹腔镜输卵管切开取胚术组患侧输卵管通畅9条(23.7%),通而不畅20条(52.6%),阻塞9条(23.7%)；腹腔镜部分输卵管切除吻合组患侧输卵管通畅2条(8.0%),通而不畅14 条(48.0%),阻塞9条(44.0%)；对三组之间输卵管通畅率进行两两比较,药物保守治疗组与腹腔镜切开取胚术组比较,差异有显著性(P<0.05),药物保守治疗组与腹腔镜部分输卵管切除吻合组比较,差异无显著性(P>0.05),腹腔镜切开取胚术组组与腹腔镜部分输卵管切除吻合组比较,差异无显著性(P>0.05)；135例患者中有31例(62条)行输卵管X线子宫输卵管碘油造影(HSG)检查, 检查结果与4D-HyCoSy检查结果对比,4D-HyCoSy检查输卵管通畅性的敏感性、特异性、准确性、阳性预测值及阴性预测值分别为95.8%,93.3%,96.8%,97.8%,93.3%,4D-HyCoSy具有较高的敏感性、特异性、准确性、阳性预测值及阴性预测值,与HSG检查具有很好的一致性。结论 4D-HyCoSy能够对输卵管通畅性进行客观评价,对临床治疗提供了客观准确依据。 |
| 关键词: 四维超声 输卵管妊娠 超声造影 |
| DOI： |
| 投稿时间：2017-08-09修订日期：2018-07-02 |
| 基金项目:甘肃省科学技术厅青年科技基金计划项目(1606RJYA294) |
|
| Comparative study on the evaluation of patency of tubal pregnancy after four - dimensional ultrasound salpingography |
| LI Tian-gang,NIE Fang |
| (Department of ultrasound diagnosis,Gansu Provincial Maternity and Child-care Hospital,Lanzhou;Department of ultrasound diagnosis,Lanzhou University Second Hospital) |
| Abstract: |
| Objectives Four-dimensional hysterosalpingo-contrast sonography（4D-HyCoSy) was used to evaluate the ipsilateral tubal patency after tubal pregnancy for providing the basis for clinical treatment. Methods There were 135 cases of tubal pregnancy after treatment were grouped basing on different tubal pregnancy treatment, including drug conservative treatment group (40 cases), laparoscopic tubal incision and embryo group(38 cases), laparoscopic partial tubal resection and anastomosis group(25 cases) and laparoscopic salpingectomy group(32 cases). The patency of tubal patency between groups was observed by contrast diagnosis of 4D-HyCoSy. Results Drug conservative treatment group ipsilateral tubal patency 4（10%）,pass and poor 20（50.0%）, blocking 16（40.0%）; laparoscopic tubal incision to take the epidermis of the ipsilateral tubal patency 9(23.7%), pass and poor 20(52.6%), blocking 9（23.7%）; Laparoscopic partial fallopian tube resection of the anastomosis of the ipsilateral tubal patency 2 (8.0%), pass and poor 14(48.0%), blocking 9 (44.0%); Between the three groups, the tubal patency rate was compared between two, the difference was significant（P<0.05）by comparing the conservative treatment group and laparoscopic incision group; There was no significant difference between the conservative treatment group and the laparoscopic partial tubal resection(P> 0.05); There was no significant difference between laparoscopic incision group and laparoscopic partial salpingectomy group(P> 0.05); Thirty-one of the 135 patients underwent tubal X-ray hysterosalpingography (HSG) examination, and the results were compared with the 4D-HyCoSy test results,the sensitivity, specificity,accuracy positive predictive value and negative predictive value of 4D-HyCoSy examination of tubal patency were 95.8%, 93.3%, 96.8%, 97.8% and 93.3%. 4D-HyCoSy had high sensitivity, specificity, accuracy, positive predictive value and negative predictive value, And X-ray lipiodol imaging examination has a very good consistency.Conclusion 4D-HyCoSy can make an objective evaluation of tubal patency, and provide objective and accurate basis for clinical treatment. |
| Key words: four-dimensional ultrasound tubal pregnancy contrast-enhanced ultrasonography |
