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实时三维子宫输卵管超声造影耐受性和安全性评估
作者:李宏波  殷立平  张玫玫  强也  马云飞 
单位:南京中医药大学附属医院 超声医学科, 江苏 南京 210029
关键词:子宫输卵管超声造影 疼痛 输卵管通畅 
分类号:R445.1;R711.6
出版年·卷·期(页码):2016·35·第三期(310-313)
摘要:

目的:评估经阴道实时三维子宫输卵管超声造影(3D HyCoSy)的耐受性以及与造影相关疼痛的预测因素。方法:160例不育症患者进行子宫输卵管超声造影后,用视觉模拟评分法(VAS)对患者两个不同时间点(T1,HyCoSy结束时;T2,HyCoSy 结束后30 min)进行疼痛程度评估,同时记录患者有无发烧、盆腔感染、腹膜炎和出血等。结果:155例(96.9%)患者完成子宫输卵管超声造影检查,其中139例(89.7%)患者经历了疼痛,3 例(1.94%)患者经历了轻度血管迷走神经反应。HyCoSy检查结束30 min后,仅2.58%(4/155)的患者仍感到不适。在评估的各影响因素中,输卵管通畅情况与HyCoSy 疼痛显著相关,年龄、月经周期、不育的持续时间和孕次与HyCoSy疼痛无显著的相关性。结论:3D HyCoSy检查耐受性好、价格低廉、流程短,值得在临床实践中广泛应用。

Objective:To assess the pain and adverse effects incurred by women undergoing Transvaginal 3-dimensional hysterosalpingo-contrast sonography(3D HyCoSy). Methods:160 consecutive women as part of infertility evaluation were included. The predictive factors of pain were assessed simultaneously. The pain experienced was then evaluated by visual analogue scale(VAS). Each patient was asked to rate her pain at two different points of time(T1, immediately after HyCoSy; T2, 30 min after HyCoSy). Through evaluating the pelvic pain immediately after HyCoSy and 30 min after HyCoSy, the pain decrease was also observed. Whether patients with fever, pelvic infections, peritonitis, bleeding were also recorded. Results:155 patients(96.9%) completed the procedure. Pain was experienced by 139 of subjects(89.7%) and 3 cases(1.94%) experienced mild vasovagal reactions. 30 min after HyCoSy procedure, only 2.58%(4/155) patients felt severe pelvic pain. Women with tubal obstruction experienced a significant increase in 3D HyCoSy-associated pain. Conclusion:3D HyCoSy is a well-tolerated examination with a very low rate of side effects and it is worthy to be widely used in clinical practice.

参考文献:

[1] KUPESIC S,PLAVSIC B M.2D and 3D hysterosalpingo-contrast-sonography in the assessment of uterine cavity and tubal patency[J].European Journal of Obstetrics & Gynecology and Reproductive Biology,2007,133(1):64-69.
[2] HE Y,GENG Q,LIU H,et al.First experience using 4-dimensional hysterosalpingo-contrast sonography with SonoVue for assessing fallopian tube patency[J].Journal of Ultrasound in Medicine,2013,32(7):1233-1243.
[3] SAVELLI L,POLLASTRI P,GUERRINI M,et al.Tolerability,side effects,and complications of hysterosalpingocontrast sonography(HyCoSy)[J].Fertility and Sterility,2009,92(4):1481-1486.
[4] NIRMAL D,GRIFFITHS A N,JOSE G,et al.Warming Echovist contrast medium for hysterocontrastsonography and the effect on the incidence of pelvic pain.A randomized controlled study[J].Human Reproduction,2006,21(4):1052-1054.
[5] GUNEY M,ORAL B,BAYHAN G,et al.Intrauterine lidocaine infusion for pain relief during saline solution infusion sonohysterography:a randomized,controlled trial[J].Journal of Minimally Invasive Gynecology,2007,14(3):304-310.

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