三维超声与X线造影诊断子宫输卵管通畅性的价值对比研究
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摘要
目的研究三维超声造影与X线碘油造影诊断子宫输卵管通畅性的价值对比,为临床诊治提供参考。方法选取2016年11月至2017年11月杭州市余杭区第一人民医院诊治的180例不孕症患者作回顾性分析。按照随机数表法平均分成两组,其中观察组90例,行三维超声造影,对照组90例,行X线碘油造影。以病理学检查结果为金标准,比较两组诊断的漏诊率、误诊率、特异度、敏感度等指标变化情况,并对比两组不良反应发生率情况。结果与病理学结果对比,X线碘油造影误诊率为50.0%,漏诊率为53.8%,敏感度为46.3%,特异度为50.0%,差异有统计学意义(P<0.05);而与病理学结果对比,三维超声造影误诊率为10.0%,漏诊率为6.3%,特异度为90.0%,敏感度为93.8%,差异无统计学意义(P>0.05);两组对比,观察组的不良反应发生率均为8.9%,对照组的不良反应发生率均为11.1%,差异具有统计学意义(P<0.05)。结论三维超声造影诊断子宫输卵管通畅性对比X线碘油造影,符合率更高,且安全性亦可,值得在临床上推广。
Objective To compare the value between three dimensional ultrasound and X-ray lipiodography in the diagnosis of uterine tubal patency, in order to provide reference for clinical diagnosis and treatment. Methods A retrospective analysis of 180 infertile patients in our hospital from November 2016 to November 2017 was performed. All the patients were randomly divided into 2 groups, where the observation group(n=90) underwent three-dimensional ultrasound and the control group(n=90) underwent X-ray lipiodolography. Taking the pathological examination results as the golden standards, the rate of missed diagnosis, misdiagnosis rate, specificity, sensitivity and the incidence of adverse reactions was compared between the two groups. Results Compared with pathologicalresults, the rate of missed diagnosis, misdiagnosis rate, specificity and sensitivity of X-ray lipiodolography was 53.8%,50.0%,46.3% and 50.0% respectively, with statistically significant differences(P<0.05), while those of three-dimensional ultrasound were 6.3%, 10.0%, 90.0% and 93.8% accordingly, without statistically significant differences(P>0.05). The incidence of adverse reaction in the observation group and control group was 8.9% and 11.1% respectively, with statistically significant difference(P<0.05). Conclusions The coincidence rate of three-dimensional ultrasound in the diagnosis of uterine tubal patencyis higher than that of X-ray lipiodolography, which is safe and worthy of clinical application.
Objective To compare the value between three dimensional ultrasound and X-ray lipiodography in the diagnosis of uterine tubal patency, in order to provide reference for clinical diagnosis and treatment. Methods A retrospective analysis of 180 infertile patients in our hospital from November 2016 to November 2017 was performed. All the patients were randomly divided into 2 groups, where the observation group(n=90) underwent three-dimensional ultrasound and the control group(n=90) underwent X-ray lipiodolography. Taking the pathological examination results as the golden standards, the rate of missed diagnosis, misdiagnosis rate, specificity, sensitivity and the incidence of adverse reactions was compared between the two groups. Results Compared with pathologicalresults, the rate of missed diagnosis, misdiagnosis rate, specificity and sensitivity of X-ray lipiodolography was 53.8%,50.0%,46.3% and 50.0% respectively, with statistically significant differences(P<0.05), while those of three-dimensional ultrasound were 6.3%, 10.0%, 90.0% and 93.8% accordingly, without statistically significant differences(P>0.05). The incidence of adverse reaction in the observation group and control group was 8.9% and 11.1% respectively, with statistically significant difference(P<0.05). Conclusions The coincidence rate of three-dimensional ultrasound in the diagnosis of uterine tubal patencyis higher than that of X-ray lipiodolography, which is safe and worthy of clinical application.
引文
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[10] 李斌,严春阳,陈春鸿,等.经阴道四维子宫输卵管超声造影在女性不孕症诊断中的临床应用[J].现代实用医学,2014,26(12):1520-1522.
[11] 张新艳.经阴道子宫输卵管四维超声造影在不孕症诊断中应用价值[J].临床心身疾病杂志,2016,22(z1):122-123.
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[14] 祝恒超,苗长龙,徐玉国,等.经阴道四维超声造影在输卵管通畅性评价中的应用价值[J].数理医药学杂志,2015,4(8):1243-1243,1244.
[15] Nouraly H,Toure A,Horo A,et al.Interest of multidetector CT virtual hysterosalpingography in the diagnosis of utero-peritoneal fistulas about 4 cases[J].Journal de gynecologie,obstetrique et biologie de la reproduction,2015,44(1):93-96.
[16] 张姗,田力,毕蓓蕾,等.经阴道实时三维子宫输卵管超声造影评价输卵管通畅性的诊断价值[J].中国临床医学影像杂志,2016,27(12):892-895.
[17] 黄晴,练丹,邱洪凤,等.经阴道实时三维超声子宫输卵管造影对输卵管通畅性的检查评价分析[J].中国性科学,2017,26(4):41-45.
[18] 范志华,李丽玲.声诺维(SonoVue)在子宫输卵管造影中的应用价值[J].海峡药学,2016,28(10):206-207.
[2] 石玮玥,蔡冬梅,黎淑芬,等.经阴道四维子宫输卵管超声造影对不孕症患者的舒适度及准确度的临床观察[J].岭南急诊医学杂志,2014,19(5):384-385,388.
[3] 闫娟,李岗,常芬琴,等.子宫输卵管超声造影在不孕症诊断中的应用[J].中国妇幼健康研究,2015,7(3):603-604,609.
[4] Tan W,Zhang J,LiuY,et al.Treatment of tubal pregnancy using comprehensive interventional methods[J].Clinical and experimental obstetrics and gynecology,2014,41(6):641-646.
[5] 田利玲,黄秀虹,黄涛,等.经阴道四维子宫输卵管超声造影在不孕症诊断中的应用价值[J].中国中西医结合影像学杂志,2014,7(2):153-155.
[6] 韩巧芳,谢玉环,罗海波,等.经阴道子宫输卵管四维超声造影评价输卵管通畅性的研究[J].生殖医学杂志,2014,23(10):788-792.
[7] Herr K,Moreno CC,FantzC,et al.Rate of detection of unsuspected pregnancies after implementation of mandatory point-of-care urine pregnancy testing prior to hysterosalpingography[J].Journal of the American College of Radiology,2013,10(7):533-537.
[8] Mahbod E,Firoozeh AA,Azizeh G.Controlled ovarian hyperstimulation and intrauterine insemination cycles in patients with unilateral tubal blockage diagnosed by hysterosalpingography[J].Iranian Journal of Reproductive Medicine,2011,9(1):32-34.
[9] 张潇潇,陈俊雅,张婧,等.经阴道四维子宫输卵管超声造影评价输卵管通畅性的研究[J].实用妇产科杂志,2015,31(3):198-201.
[10] 李斌,严春阳,陈春鸿,等.经阴道四维子宫输卵管超声造影在女性不孕症诊断中的临床应用[J].现代实用医学,2014,26(12):1520-1522.
[11] 张新艳.经阴道子宫输卵管四维超声造影在不孕症诊断中应用价值[J].临床心身疾病杂志,2016,22(z1):122-123.
[12] Bekir SU,Mehmet Y,Gulengul K,et al.Comparison of four different pain relief methods during hysterosalpingography:A randomized controlled study[J].Pain research Management,2015,20(2):107-111.
[13] 乔婷.四维子宫输卵管超声造影治疗不孕不育的临床观察[J].中国卫生标准管理,2015,5(28):190-191.
[14] 祝恒超,苗长龙,徐玉国,等.经阴道四维超声造影在输卵管通畅性评价中的应用价值[J].数理医药学杂志,2015,4(8):1243-1243,1244.
[15] Nouraly H,Toure A,Horo A,et al.Interest of multidetector CT virtual hysterosalpingography in the diagnosis of utero-peritoneal fistulas about 4 cases[J].Journal de gynecologie,obstetrique et biologie de la reproduction,2015,44(1):93-96.
[16] 张姗,田力,毕蓓蕾,等.经阴道实时三维子宫输卵管超声造影评价输卵管通畅性的诊断价值[J].中国临床医学影像杂志,2016,27(12):892-895.
[17] 黄晴,练丹,邱洪凤,等.经阴道实时三维超声子宫输卵管造影对输卵管通畅性的检查评价分析[J].中国性科学,2017,26(4):41-45.
[18] 范志华,李丽玲.声诺维(SonoVue)在子宫输卵管造影中的应用价值[J].海峡药学,2016,28(10):206-207.