子宫输卵管超声造影伞端溢出时间与妊娠率的相关性研究
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摘要
目的通过分析子宫输卵管超声造影输卵管伞端溢出时间与促排卵或自然妊娠结局的相关性,探讨输卵管伞端溢出时间的不同在评价输卵管蠕动功能方面的应用价值。方法选取我院不孕不育症生殖门诊及广州医科大学第三附属医院生殖中心就诊的161例患者,进行子宫输卵管超声造影(HyCoSy)检查,记录输卵管伞端溢出时间及卵巢周围环状包绕、盆腔弥散分布特点。参照《子宫输卵管超声造影》[1]将造影剂混合液在输卵管伞端溢出时间的不同,分为2组,第1组<48s溢出组,第2组>48s溢出组,未见溢出者(8例给予剔除),对两组患者进行促排卵治疗或指导同房自然妊娠,并随访1年,观察两组间的妊娠率,分析总结子宫输卵管超声造影伞端溢出时间与促排卵或自然妊娠结局的相关性。结果双侧输卵管超声造影伞端溢出时间的不同组间与促排卵或自然妊娠成功率比较,差异有统计学意义(χ2=10.538,P<0.05)。单侧输卵管超声造影伞端溢出时间不同组间与促排卵或自然妊娠成功率比较,差异有统计学意义(χ2=5.617、6.739,P<0.05)。左、右侧输卵管超声造影伞端溢出时间相同组别之间与促排卵或自然妊娠成功率比较,差异无统计学意义(P>0.05)。Logistic回归曲线分析结果显示,双侧输卵管超声造影伞端溢出时间快慢是促排卵或自然妊娠结局的影响因素(P<0.05)。Logistic回归方程预测妊娠率的受试者特征(ROC)曲线下面积为0.873 [95%CI (0.847、0.914)]。结论子宫输卵管超声造影伞端溢出时间的快慢与促排卵或自然妊娠率有相关性,即溢出时间越快,输卵管的蠕动功能越好,妊娠成功率越高。
Objective To explore the clinical application value of the duration of umbrella end overflow in evaluating the function of fallopian tubes by analyzing the correlation between the time of hysterosalpingography and natural pregnancy outcome.Methods Selected from in xiamen city maternal and child health care infertility and reproductive clinic in guangzhou medical university third hospital infertility reproductive outpatient clinic of 161 patients,the uterus oviduct contrast-enhanced ultrasound inspection,record the oviduct umbrella end of overflow time and ovarian ring often surroundedpelvic dispersion characteristics of overflow time According to《hysterosalpingography》the contrast agent in oviduct umbrella end different,divided into 2 groups,1 group less than 48 seconds,2 group 48 seconds overflow group,the patients were followed up for 1 year to observe the pregnancy rate between different groups,and the correlation between the time of hysterosalpingography umbrella end overflow and the natural pregnancy outcome was analyzed.Results There were statistically significant differences between the two groups(χ2=10.538,P<0.05).There were statistically significant differences in the success rate of spontaneous pregnancy between different groups(χ2=5.617,6.739,P<0.05).There was no statistically significant difference(P>0.05)in the success rate of spontaneous pregnancy between the same groups of left and right oviducal ceus(ceus).The results of multiple Logistic regression analysis showed that the rapid overflow time of the umbrella end of bilateral salpinx was the influencing factor of natural pregnancy outcome(P<0.05).The area under the ROC curve was 0.873[95%CI(0.847,0.914)].Conclusions There is a correlation between the rate of spontaneous pregnancy and the rate of spontaneous pregnancy.
Objective To explore the clinical application value of the duration of umbrella end overflow in evaluating the function of fallopian tubes by analyzing the correlation between the time of hysterosalpingography and natural pregnancy outcome.Methods Selected from in xiamen city maternal and child health care infertility and reproductive clinic in guangzhou medical university third hospital infertility reproductive outpatient clinic of 161 patients,the uterus oviduct contrast-enhanced ultrasound inspection,record the oviduct umbrella end of overflow time and ovarian ring often surroundedpelvic dispersion characteristics of overflow time According to《hysterosalpingography》the contrast agent in oviduct umbrella end different,divided into 2 groups,1 group less than 48 seconds,2 group 48 seconds overflow group,the patients were followed up for 1 year to observe the pregnancy rate between different groups,and the correlation between the time of hysterosalpingography umbrella end overflow and the natural pregnancy outcome was analyzed.Results There were statistically significant differences between the two groups(χ2=10.538,P<0.05).There were statistically significant differences in the success rate of spontaneous pregnancy between different groups(χ2=5.617,6.739,P<0.05).There was no statistically significant difference(P>0.05)in the success rate of spontaneous pregnancy between the same groups of left and right oviducal ceus(ceus).The results of multiple Logistic regression analysis showed that the rapid overflow time of the umbrella end of bilateral salpinx was the influencing factor of natural pregnancy outcome(P<0.05).The area under the ROC curve was 0.873[95%CI(0.847,0.914)].Conclusions There is a correlation between the rate of spontaneous pregnancy and the rate of spontaneous pregnancy.
引文
[1]王莎莎.子宫输卵管超声造影[M].北京:军事医学科学出版社,2014.
[2]张玉,任豆豆,刘效群,等.实时超声造影检查输卵管性不孕症结果的评估[J].中国超声医学杂志,2018,34(8):736-739.
[3]GUASINA F,BELLUSSI F,MORGANELLI G,et al.Electronic spatiotemporal image correlation improves four-dimensional fetal echocardiography[J].Ultrasound Obstet Gynecol,2018,51(3):357-360.
[4]陈梅,张盛敏,薛念余,等.子宫输卵管超声造影对输卵管通畅性的诊断研究[J/OL].中华医学超声杂志:电子版,2016,13(7):531-537.
[5]MAHEUX-LACROIX,BOUT,MOORE L,et al.Hysterosalpingosonography for diagnosing tubal occlusion in subfertile w om en:a system atic review with m eta-ana lysis[J].Human Reproduction,2014,29(5):953-963.
[6]王锦惠,门殿霞,于小芳,等.经阴道子宫输卵管动态三维超声造影评价输卵管通畅性的有效性和安全性[J].中国超声医学杂志,2015,31(11):1016-1019.
[7]MERZ E,PASHAJ S.Advantages of 3Dultrasound in the assessment of fetal abnormalities[J].J Penerinat Med,2017,45(6):643-650.
[8]WANG W Q,ZHOU Q L,CHEN Z Y,et al.Assessment of Fallopian Tube Fimbria Patency With Four-Dimensional Hysterosalpingo-Contrast Sonography In Infertile Women[J].Journal of Ultrasound in Mdicine,2017,36(10):2061-2069.
[9]张玉,李蕊,李海燕,等.子宫输卵管动态三维超声造影在评估输卵管通畅性中的应用[J].中国超声医学杂志,2015,31(9):816-818.
[10]梁娜,吴青青,高凤云,等.经阴道三维子宫输卵管超声造影诊断先天性子宫畸形的应用价值[J].中国超声医学杂志,2015,31(6):543-545.
[11]王伟群,周秋兰,陈智毅,等.经阴道四维超声造影联合宫腔通液术评价输卵管伞端通畅性的研究[J].中华超声影像学杂志,2017,26(8):57-61.
[12]WANG W Q,ZHOU Q L,CHEN Z Y,et al.Influence Factors on Contrast Agent Venous Intravasation during Transvaginal Four-Dimensional Hysterosalpingo-Contrast Sonography[J].Journal of Ultrasound in Medicine,2018,36(3):861-867.
[13]张莘,狄娜,冯淑英,等.不同三维扫描质量对输卵管超声造影准确性的影响[J].中国超声医学杂志,2017,33(12):1104-1107.
[2]张玉,任豆豆,刘效群,等.实时超声造影检查输卵管性不孕症结果的评估[J].中国超声医学杂志,2018,34(8):736-739.
[3]GUASINA F,BELLUSSI F,MORGANELLI G,et al.Electronic spatiotemporal image correlation improves four-dimensional fetal echocardiography[J].Ultrasound Obstet Gynecol,2018,51(3):357-360.
[4]陈梅,张盛敏,薛念余,等.子宫输卵管超声造影对输卵管通畅性的诊断研究[J/OL].中华医学超声杂志:电子版,2016,13(7):531-537.
[5]MAHEUX-LACROIX,BOUT,MOORE L,et al.Hysterosalpingosonography for diagnosing tubal occlusion in subfertile w om en:a system atic review with m eta-ana lysis[J].Human Reproduction,2014,29(5):953-963.
[6]王锦惠,门殿霞,于小芳,等.经阴道子宫输卵管动态三维超声造影评价输卵管通畅性的有效性和安全性[J].中国超声医学杂志,2015,31(11):1016-1019.
[7]MERZ E,PASHAJ S.Advantages of 3Dultrasound in the assessment of fetal abnormalities[J].J Penerinat Med,2017,45(6):643-650.
[8]WANG W Q,ZHOU Q L,CHEN Z Y,et al.Assessment of Fallopian Tube Fimbria Patency With Four-Dimensional Hysterosalpingo-Contrast Sonography In Infertile Women[J].Journal of Ultrasound in Mdicine,2017,36(10):2061-2069.
[9]张玉,李蕊,李海燕,等.子宫输卵管动态三维超声造影在评估输卵管通畅性中的应用[J].中国超声医学杂志,2015,31(9):816-818.
[10]梁娜,吴青青,高凤云,等.经阴道三维子宫输卵管超声造影诊断先天性子宫畸形的应用价值[J].中国超声医学杂志,2015,31(6):543-545.
[11]王伟群,周秋兰,陈智毅,等.经阴道四维超声造影联合宫腔通液术评价输卵管伞端通畅性的研究[J].中华超声影像学杂志,2017,26(8):57-61.
[12]WANG W Q,ZHOU Q L,CHEN Z Y,et al.Influence Factors on Contrast Agent Venous Intravasation during Transvaginal Four-Dimensional Hysterosalpingo-Contrast Sonography[J].Journal of Ultrasound in Medicine,2018,36(3):861-867.
[13]张莘,狄娜,冯淑英,等.不同三维扫描质量对输卵管超声造影准确性的影响[J].中国超声医学杂志,2017,33(12):1104-1107.