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目的 探讨数字减影血管造影(DSA)下行一次性导管法动态子宫输卵管造影(HSG)的临床应用价值。方法 回顾性分析2021年11月至2023年9月因不孕症于江西省妇幼保健院行DSA动态HSG检查的648例患者资料，根据造影方法分为一次性导管法组(358例)和金属导管法组(290例),比较两组病例HSG过程参数(置管时长、曝光时长、对比剂用量、检查时长、宫腔和输卵管显影情况和图像质量)、术中及术后30 min疼痛(视觉模拟评分法，VAS)评分，以及术后不良反应(阴道流血、恶心呕吐及头晕乏力)的差异。结果 一次性导管法动态HSG术中及术后30 min VAS评分均较金属导管法动态HSG更低，前者置管时长和检查时长更短，对比剂用量更少，且术后阴道出血发生率更低，差异均有统计学意义(P<0.05);在图像质量、宫腔和输卵管显影情况、曝光时长、术后恶心呕吐及头晕乏力方面，组间差异均无统计学意义(P>0.05)。结论 一次性导管法动态HSG操作简单，置管快捷，缩短了置管时长和检查时长，无需钳夹或牵拉宫颈，较大程度上减轻了疼痛，减少了术后阴道出血发生的概率及对比剂用量，值得临床推广使用。
Abstract：Objective:To explore the clinical application value of dynamic hysterosalpingography(HSG) with a disposable cannula method in digital subtraction angiography(DSA).Methods:A retrospective analysis was performed on 648 patients who underwent dynamic HSG examination by DSA for infertility at Jiangxi Provincial Maternal and Child Health Hospital from November 2021 to September 2023. The patients were divided into the disposable cannula group(358 cases) and the metal cannula group(290 cases) according to the method of HSG. The parameters during HSG procedures(catheterization time, exposure time, the dose of contrast agent, examination duration, imaging conditions of uterine cavity and fallopian tube, and image quality),intraoperative and 30-minute postoperative visual analogue scale(VAS) pain scores, as well as postoperative adverse reactions(vaginal bleeding, nausea and vomiting, and dizziness and fatigue) were compared between the two groups.Results:The intraoperative and 30-minute postoperative VAS pain scores of the disposable cannula group were lower than those of the metal cannula group, and the former had shorter catheterization and examination duration, used less dose of contrast agent, and had a lower incidence of postoperative vaginal bleeding, showing statistically significant difference totally(P<0.05). However, there were no statistically significant differences in image quality, imaging conditions of uterine cavity and fallopian tube, exposure duration, the incidence of postoperative nausea and vomiting, as well as dizziness and fatigue between the two groups(P>0.05).Conclusions:The disposable cannula method for HSG is simple to perform, and could facilitate quick catheterization, reduce catheterization and examination duration, eliminate the need for cervical clamping or traction, significantly alleviate pain, and reduce the probability of postoperative vaginal bleeding as well as the dose of contrast agent used. It is worth promoting its clinical application.
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基本信息:
中图分类号:R711.6
引用信息:
[1]熊梦怡,何斌,李志娟,等.数字减影血管造影下行一次性导管法动态子宫输卵管造影的临床应用价值[J].生殖医学杂志,2025,34(01):80-86.
基金信息:
江西省卫生健康委科技项目(202211145); 江西省中医药管理局科技计划项目(2023A0115)
2025-01-15
2025-01-15