两种造影剂在输卵管造影检查中的临床应用比较

• 作 者: 陆月华 沈斌仙 王雅红 张建丽 俞国英
• 机 构: 浙江省桐乡市第一人民医院超声科,浙江省桐乡市第一人民医院妇产科,
• 出 处: 中国妇幼保健
• 发表日期: 2011年12期
• 关键词: 不孕症 子宫输卵管造影术 两种造影剂 阴道超声

目的:探讨超声实时监测下两种造影剂在子宫输卵管造影检查中的应用价值,了解不孕症中输卵管因素不孕的发病情况及治疗效果。方法:利用维生素B6注射液与5%碳酸氢钠注射液的混合液及双氧水作为两种声学造影剂,行子宫输卵管造影术,实时观察并比较这两种造影剂在产生微气泡量、微气泡出现时间、微气泡高峰持续时间、微气泡总持续时间及副作用这几项因素的超声动态图像特征,并以此确定输卵管是否通畅及具体阻塞部位。结果:61例不孕症患者中,双侧通畅20例,输卵管不全梗阻或一侧不通畅35例,双侧完全性梗阻6例。结论:两种造影剂在子宫输卵管造影术中表现不一致。与双氧水组比较,维生素B6注射液加碳酸氢钠混合液产气量大,声阻抗差异明显,微气泡停留时间较长,且副作用发生率明显少于双氧水组。其作为造影剂效果明显优于双氧水,值得临床推广应用。

OBJECTIVE: To investigate the value of two contrast agents in the detection of hysterosalpingography under real-time ultrasound and to understand the incidence of tubal infertility and its therapeutic effect. Methods: Using the mixed solution of vitamin B6 injection and 5% sodium bicarbonate injection and hydrogen peroxide as two kinds of acoustic contrast medium, we performed the hysterosalpingography and observed and compared the two kinds of contrast medium in real time. Appearance time, duration of microbubble peak, total duration of microbubble and side effects of ultrasound dynamic image features, and to determine tubal patency and specific obstruction site. Results: In 61 cases of infertility patients, bilateral unilateral patency in 20 cases, tubal insufficiency or unilateral patency in 35 cases, bilateral complete obstruction in 6 cases. CONCLUSIONS: The two contrast agents show inconsistent results in hysterosalpingography. Compared with the hydrogen peroxide group, vitamin B6 injection combined with sodium bicarbonate mixture gas production, significant differences in acoustic impedance, residence time of microbubbles longer, and the incidence of side effects was significantly less than the hydrogen peroxide group. Its effect as a contrast agent is obviously superior to that of hydrogen peroxide, worthy of clinical application.