目的: 探讨经阴道超声监测下行子宫输卵管通液检查对于不育女性患者输卵管通畅性检查在不孕门诊的应用价值。方法: 选取不孕门诊就诊患者中有输卵管检查需求以及输卵管检查适应证的患者共200例作为研究对象,均采用(迈瑞)彩色多普勒超声系统DC-N3S(配备阴道探头)于术前、术中、术后实时监测。液体配制:庆大霉素8万单位,糜蛋白酶4 000 U,地塞米松5 mg,生理盐水60 mL。通过观察液体在子宫、输卵管的流动声像,以盆腔内积液分布以及阴道返流情况判断输卵管通畅度。结果: 输卵管通畅121例;输卵管通畅性异常79例(双侧不通21例,单侧不通26例,双侧或单侧输卵管通而不畅32例 ),其中12例于外院经子宫输卵管造影检查 ( HSG) 诊断,诊断结果符合通液结果。结论: 经阴道超声监测下子宫输卵管通液检查操作准确性高,安全,费用低,患者接受度高。

Objective: To explore the application value of hydrotubation under transvaginal ultrasound monitoring for tubal patency examination of infertile women in infertility clinic. Methods: A total of 200 patients with tubal examination requirements and indications for tubal examination in infertility outpatients were selected as the research objects. DC-N3S (equipped with vaginal probe) color Doppler ultrasound system (Mindray) was used for real-time monitoring before, during and after operation. Liquid preparation: gentamicin 80 000 units, chymotrypsin 4000 U, dexamethasone 5 mg, normal saline 60 mL. By observing the flow of fluid in the uterus and fallopian tubes, the patency of fallopian tubes was judged by the distribution of fluid in the pelvic cavity and vaginal reflux. Results: A total of 121 patients were fallopian tube patency; 79 patients were abnormal fallopian tube patency (21 patients were bilateral obstruction, 26 patients were unilateral obstruction, and 32 patients were bilateral or unilateral fallopian tube obstruction). Among them, 12 patients were diagnosed by hysterosalpingography (HSG) in other hospitals, and the diagnosis results were consistent with the results of hydrotubation. Conclusion: Hydrotubation under transvaginal ultrasound monitoring has the advantages of high accuracy, safety, low cost and high patient acceptance.