超声引导下输卵管造影诊断不孕症的优势

Advantage of Hysterosalpingocontrast Sonography in the Diagnosis of Infertility

目的探讨超声引导下输卵管造影诊断不孕症的优势。方法选取2012-02-01—2012-11-30在我院门诊就诊的不孕症患者106例,均进行超声引导下输卵管造影。其中28例患者在进行超声引导下输卵管造影前1年左右做过输卵管碘油造影。采用一致性检验将28例患者55条输卵管(其中1例切除了一侧输卵管)的碘油造影结果及超声引导下输卵管造影结果进行对比。结果超声引导下输卵管造影可以清晰显示输卵管的各个节段,并可准确评价其通畅性。106例患者中,129条输卵管通畅,47条输卵管通而不畅,31条输卵管阻塞,4条已切除输卵管,1条造影失败(患者为纵膈子宫,导管插入右侧宫腔,左侧输卵管造影失败)。28例患者碘油造影结果与超声引导下输卵管造影结果进行对比,Kappa值=0.39,提示两种方法的一致性差。结论输卵管超声造影可以显示更纤细的输卵管,更准确地反映输卵管的通畅情况,且安全性好、操作简单、副作用较小。故在诊断不孕症方法中,超声引导下输卵管造影比碘油造影更有优势。

Objective To investigate the advantage of hysterosalpingocontrast sonography in the diagnosis of infertility.Methods 106 infertile outpatients from February 1,2012 to November 30,2012 were given hysterosalpingocontrast sonography.28 patients had hysteroslpinogrphy one year before the hysterosalpingocontrast sonography.The effect of the 55 fallopian tubes of the 28 patients(one fallopian tube was cut off) after hysteroslpinogrphy and the results of the hysterosalpingocontrast sonography were compared by using Kappa identity test.Results Hysterosalpingocontrast sonography could clearly display each segment of the fallopian tube and could evaluate its condition.Among the 106 patients,129 fallopian tubes were totally unobstructed,47 tubes were mildly obstructed,31 tubes were seriously obstructed and 4 tubes were cut off.One patient had failed hysterosalpingocontrast sonography(the patient was mediastinum uterus,the catheter was inserted into the right uterine cavity,and the left fallopian tube had failed sonography).The results of hysteroslpinogrphy in the 28 patients were compared with the results of the hysterosalpingocontrast sonography,and the comparison showed Kappa = 0.39 and a poor consistency.Conclusion Hysterosalpingocontrast sonography can show slender fallopian tube and reflect the condition of fallopian tube more accurately with good safety,simple operation and less side effects.It has advantage in the diagnosis of infertility than hysteroslpinogrphy.