目的

探讨实时动态三维无痛输卵管超声造影在临床中的应用价值。

方法

前瞻性选取2021 年6 月至2024 年3 月于杭州市中医院接受疑似输卵管原因导致不孕的163 例女性作为研究对象，按照随机数字表法分为对照组、试验组和观察组，对照组59 例117 条输卵管，试验组54 例103条输卵管，观察组50 例100 条输卵管。对照组采用X 线子宫输卵管造影，试验组采用实时动态三维无痛（于麻醉状态下进行）输卵管超声造影，观察组采用实时动态三维输卵管超声造影进行输卵管通畅性的检查及诊断。统计3 组患者造影图像的优良率、输卵管通畅性诊断准确率和不良反应发生率，采用χ² 检验对比组间差异。

结果

诊断后试验组的造影图像优良率高于对照组（91.26% vs 81.20%），差异具有统计学意义（χ²=4.585，P＜0.001）。输卵管通畅性诊断方面，试验组诊断阻塞率高于对照组和观察组（89.32% vs 77.00% vs 76.92%），差异具有统计学意义（χ²=5.892、5.523，P=0.015、0.019）。不良反应发生情况，对照组和观察组疼痛发生概率高于试验组（20.34% vs 20.00% vs 0），差异具有统计学意义（χ²=12.288、11.949，P 均＜0.001）；对照组和观察组恶心呕吐发生概率高于试验组（11.86% vs 10.00% vs 0），差异具有统计学意义（χ²=4.941、5.673，P=0.026、0.023）。

结论

实时动态三维无痛输卵管超声造影在诊断输卵管通畅性中效果更好，图像更清晰，诊断准确率高，可有效降低患者的不良反应。

Objective

To evaluate the clinical value of real-time dynamic three-dimensional painless tubal contrast-enhanced ultrasonography.

Methods

One hundred and sixty-three women who had suspected tubal infertility at Hangzhou Hospital of Traditional Chinese Medicine from June 2021 to March 2024 were selected as the study subjects.They were divided into a control group, an experimental group,and an observation group by the random number table method, involving 59 women in the control group with 117 fallopian tubes, 54 women in the experimental group with 103 fallopian tubes, and 50 women in the observation group with 100 fallopian tubes.The control group underwent X-ray hysterosalpingography,and real-time dynamic three-dimensional painless (performed under anesthesia) tubal contrast-enhanced ultrasonography was used in the experimental group.Real-time dynamic three-dimensional tubal contrastenhanced ultrasonography was used in the observation group.The three groups of patients were statistically analyzed for the excellent rate of contrast images obtained, the accuracy of diagnosis of tubal patency, and the rate of adverse reactions.The comparison of continuous variables within the group was performed using multifactorial repeated-measures analysis of variance, and categorical variables between groups were compared using the χ² test.

Results

The excellent rate of contrast images in the experimental group was higher than that of the control group (91.26% vs 81.2%; χ²=4.585, P＜0.001).In terms of the diagnosis of tubal patency,the rate of impatency in the experimental group was significantly higher than that of the control group and the observation group (89.32% vs 77.00%, χ²=5.892, P=0.015; 89.32% vs 76.92%, χ²=5.523, P=0.019).In terms of adverse reactions, the rate of pain in the control group and observation group was significantly higher than that of the experimental group (20.34% vs 0, χ²=12.288, P＜0.001; 20.00% vs 0, χ²=11.949, P＜0.001),and the rate of nausea and vomiting in the control group and observation group was significantly higher than that of the experimental group (11.86% vs 0, χ²=4.941, P=0.026;10.00% vs 0, χ²=5.673, P=0.023).

Conclusion

Real-time dynamic three-dimensional painless tubal contrast-enhanced ultrasonography is more effective in asessing tubal patency, with images having higher quatlity, and it can improve the diagnostic accuracy and effectively reduce the rate of adverse reactions.