目的 探讨造影剂温度对经阴道四维子宫输卵管超声造影检查（TVS 4D-Hycosy）以疼痛为主不良反应的影响情况。 方法 双盲随机对照试验。纳入220例接受TVS 4D-Hycosy检查患者随机分配（1∶1），分别接受预热造影剂（38 ℃）和常温造影剂（22 ~ 26 ℃）检查，使用Stacey评分量表综合评价疼痛、恶心、呕吐等不良反应及使用NRS评分量表单独评价疼痛，对比两组宫腔置管后、检查过程中不良反应发生情况；检查结束后对比两组持续疼痛0 h、< 0.5 h、< 1 h、1 ~ 24 h、> 24 h各时间段人数比例。 结果 宫腔置管后两组Stacey不良反应评分及NRS疼痛评分差异无统计学意义（Z = 0.231、-0.341，均P > 0.05）；检查过程中预热组患者Stacey不良反应评分及NRS疼痛评分均低于室温组（Z = 2.906、3.837，均P < 0.05），且中重度不良反应比例预热组低于室温组（χ² = 7.502，P < 0.05），两组差异有统计学意义；检查结束后两组持续疼痛0 h、< 0.5 h、< 1 h、1 ~ 24 h、> 24 h各时间段人数比例差异无统计学意义（χ² = 0.141、0.566、0.697、0.373，均P > 0.05）。 结论 恒温预热造影剂可减少TVS 4D-Hycosy检查过程中的不良反应，是一种简单有效减轻患者痛苦的方法。

Objective To investigate the effect of contrast agent temperature on adverse reactions of transvaginal four?dimensional hysterosalpingo?contrast sonography （TVS 4D?Hycosy） with pain as the main manifestation. Methods Double?blind randomized controlled study. A total of 220 patients who underwent TVS 4D?Hycosy examination were randomly assigned （1∶1） to receive preheated contrast agent （38 ℃） and normal temperature contrast agent （22 ~ 26 ℃） respectively. The Stacey scoring scale was used to comprehensively evaluate pain， nausea， vomiting and other adverse reactions and NRS scoring scale were used to evaluate pain alone， and the occurrence of adverse reactions after intrauterine catheterization and during the examination was compared between the two groups. After the inspection， compare the proportion of people with persistent pain at 0 h， < 0.5 h， < 1 h， 1 ~ 24 h， and > 24 h between the two groups. Result There was no significant difference in Stacey adverse reaction score and NRS pain score between the two groups after intrauterine catheterization （Z = 0.231， -0.341， both P > 0.05）. During the examination， the Stacey adverse reaction score and NRS pain score in the preheated group were lower than those in the room temperature group （Z = 2.906， 3.837， both P < 0.05）， and the proportion of moderate and severe adverse reactions in the preheated group was lower than that in the room temperature group （χ² = 7.502， P < 0.05）， the difference between the two groups was statistically significant. After the examination， there was no significant difference in the proportion of people with persistent pain at 0 h， < 0.5 h， < 1 h， 1 ~ 24 h， and > 24 h between the two groups （χ² = 0.141， 0.566， 0.697， 0.373， all P > 0.05）. Conclusions Thermostatic preheated contrast agent reduces adverse reactions during the TVS 4D?Hycosy and is a simple and effective way to alleviate patient suffering.