实时三维子宫输卵管造影的不良反应与处理

发布时间：2018-10-15 12:59

【摘要】：目的探讨经阴道实时三维子宫输卵管造影(3D-Hy Co Sy)过程中不良反应及处理措施。资料与方法回顾性分析2014年12月-2016年8月南京中医药大学附属江苏省中医院976例因不孕症就诊行3D-Hy Co Sy的患者。采用视觉模拟评分法(VAS)进行疼痛程度评估,同时记录患者造影剂逆流、呕吐、晕厥、过敏等发生情况,比较不同超声表现患者的不良反应情况。结果疼痛VAS评分0级66例(6.76%)、轻度疼痛346例(35.45%)、中度疼痛374例(38.32%)、重度疼痛190例(19.47%)。随着输卵管阻塞程度的增加,疼痛程度逐渐加重,并成为患者最常见的不良反应;其次呕吐15例(1.54%)、晕厥1例(0.10%)、过敏1例(0.10%)、造影剂逆流120例(12.30%)。超声表现异常患者不良反应发生率明显高于超声表现正常者,差异有统计学意义(χ~2=29.02,P0.01)。结论 3D-Hy Co Sy检查应用广泛,在关注其临床应用价值的同时,也需提高对该检查安全性及相关不良反应的认识,造影前、中、后各期应密切观察患者的状态,警惕晕厥和过敏反应的发生,做好应急处置的临床准备。
[Abstract]:Objective to investigate the adverse reactions and management of transvaginal real-time three-dimensional hysterosalpingography (3D-Hy Co Sy). Materials and methods from December 2014 to August 2016, 976 patients with 3D-Hy Co Sy in Jiangsu Provincial Hospital of traditional Chinese Medicine affiliated to Nanjing University of traditional Chinese Medicine were analyzed retrospectively. Visual analogue score (VAS) was used to evaluate the degree of pain, and the adverse reactions of patients with different ultrasound manifestations were compared by recording the incidence of contrast agent reflux, vomiting, syncope and allergy. Results there were 66 cases (6.76%) with VAS grade 0, 346 cases (35.45%) with mild pain, 374 cases (38.32%) with moderate pain and 190 cases (19.47%) with severe pain. With the increase of the degree of tubal obstruction, the degree of pain gradually aggravated and became the most common adverse reaction, followed by vomiting in 15 cases (1.54%), syncope in 1 case (0.10%), hypersensitivity in 1 case (0.10%), contrast agent reflux in 120 cases (12.30%). The incidence of adverse reactions in abnormal ultrasound patients was significantly higher than that in normal ultrasound patients (蠂 ~ 2 = 29.02, P 0.01). Conclusion 3D-Hy Co Sy examination is widely used. It is necessary to improve the safety and adverse reactions of the 3D-Hy Co Sy examination while paying close attention to its clinical application value. The state of the patients should be closely observed before, during and after the examination. Be alert to syncope and allergic reaction and prepare for emergency management.
【作者单位】：南京中医药大学附属医院超声医学科;
【基金】：江苏省中医药局科技项目(LZ13065)
【分类号】：R711.6;R816.91

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