Jin Bin-Bin, Ma Yan, Zhao Xiu-Hua, Teng Yi-Ling, Zhu Shang-Yong
Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
Int J Gen Med. 2022 Oct 7;15:7709-7718. doi: 10.2147/IJGM.S380917. eCollection 2022.
To analyze the risk factors of the operators on contrast agent intravasation during hysterosalpingo-contrast sonography (HyCoSy).
We retrospectively collected 399 infertile women who underwent HyCoSy by the same sonographer. These patients were divided into two groups according to the way how the assistants connected the syringe to the uterus radiography catheter to inject the contrast agent. We analyzed whether the use of different contrast bolus injection methods had any influence on the incidence of intravasation during HyCoSy.
There was no significant difference between the two groups with different cross-sectional areas of the syringe outflow tract in the risk variables for intravasation, but the intravasation rates of the two groups were different, 26.4% in group A and 17.1% in group B, <0.05. The primary manifestation was that when both fallopian tubes were unobstructed, the intravasation rate of group B with smaller cross-sectional area of the outflow tract of the syringe was lower, and the difference was statistically significant. The inferences drawn from our physics model were also in line with the clinical results.
The influence of different operators on the contrast agent intravasation rate of HyCoSy cannot be ignored. The assistants of HyCoSy examination should inject the contrast agent slowly and steady, and a needle can be used as a flow restrictor to control the flow into the uterine cavity per unit time, slow down the rising speed of intrauterine pressure, and avoid the accumulation of contrast agent in the uterine cavity, so as to reduce the intravasation caused by operator factors.
分析子宫输卵管超声造影（HyCoSy）过程中操作人员导致造影剂血管内渗漏的危险因素。
我们回顾性收集了399例由同一位超声检查医师进行HyCoSy检查的不孕女性。根据助手将注射器与子宫造影导管连接以注入造影剂的方式，将这些患者分为两组。我们分析了不同造影剂推注方法的使用对HyCoSy过程中血管内渗漏发生率是否有任何影响。
两组注射器流出道横截面积不同，但在血管内渗漏风险变量方面无显著差异，但两组的血管内渗漏率不同，A组为26.4%，B组为17.1%，P<0.05。主要表现为当双侧输卵管通畅时，注射器流出道横截面积较小的B组血管内渗漏率较低，差异有统计学意义。我们从物理模型得出的推论也与临床结果一致。
不同操作人员对HyCoSy造影剂血管内渗漏率的影响不容忽视。HyCoSy检查的助手应缓慢、稳定地注入造影剂，可用针头作为流量限制器来控制单位时间内流入宫腔的流量，减缓宫腔内压力上升速度，避免造影剂在宫腔内积聚，从而减少操作人员因素导致的血管内渗漏。
