Clinical Value Of Hysterosalpingo-contrast-sonography In Evaluation Of Tubal Patency In Patients With Tubal Pregnancy After Treatment

Objective:To assess the clinical value of real time three-dimensional hysterosalpingo-contrast-sonography(RT-3D-Hy Co Sy)in evaluation of tubal patency in patients with tubal pregnancy after treatment.Methods:103 patients with tubal pregnancy treated in Gansu Province Maternal and child-care Hospital from August 2015 to May 2017 were selected,103 patients was divided into three groups according to their therapies:drug conservative treatment group 40 cases(group A),laparoscopic tubal incision and embryo group 38 case(group B),laparoscopic partial tubal resection and anastomosis group 25 cases(group C),tubal patency in 103 patients was evaluated by using RT-3D-Hy Co Sy,Taken the results of X-ray hysterosalpingography examination(X-HSG)as reference standard,the diagnosticefficiency of RT-3D-Hy Co Sy in estimating fallopian tubal patency was calculated.A total of 79 patients with tubal pregnancy treated in Gansu Province Maternal and child-care Hospital from March 2016 to January 2019 underwent laparoscopic examination and RT-3D-Hy Co Sy,tubal patency in 79 patients was evaluated by using RT-3D-Hy Co Sy.The sensitivity,specificity,positive predictive value,and negative pre-dictivevalue of RT-3D-Hy Co Sy were calculated.Results:(1)RT-3D-Hy Co Sy showed that 4 fallopian tubes were unobstructed,20 fallopian tubes were poor pass,16 fallopian tubes were obstructed in group A.11 fallopian tubes were unobstructed,20 fallopian tubes were poor pass,7 fallopian tubes were obstructed in group B.2 fallopian tubes were unobstructed,14 fallopian tubes were poor pass,9 fallopian tubes were obstructed in group C.The difference of tubal patency rate was significant by comparing the group A and group B,while there was no significant difference between the group A and the group C,and there was no significant difference between group B and group C.(2)26 patients(52 fallopian tubes)underwent X-HSG,and the results were compared with the RT-3D-Hy Co Sy test,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 97.5%,91.7%,96.2%,97.5% and 91.7%,respectively.Kappaindex was 0.880,RT-3D-Hy Co Sy and X-HSG were highly consistent in evaluation of tubal patency in patients with tubal pregnancy after treatment.RT-3D-Hy Co Sy showed that 68 fallopian tubes were unobstructed,61 fallopian tub es were poor pass and 29 fallopian tubes were obstructed.The patency coincidence rat e was 73.5%,patency coincidence rate was 73.8%,obstruction coincidence rate was 69.0%,accuracy was 88.0%,sensitivity was 92.9%,specificity was 81.3%,positive predictive value was 90.7%,negative predictive value were 69.0%.Kappa index was 0.675,RT-3D-Hy Co Sy and laparoscopic examination were highly consistent in evaluatio n oftubal patency in patients with tubal pregnancy after treatment.Conclusion:RT-3D-Hy Co Sy provides objective and accurate basis for clinical treatment as new ideas and methods for the evaluation of fallopian tube patency which is non-invasive,non-radioactive and safe.