子宫输卵管造影与宫腹腔镜联合探查诊断输卵管通畅性的对比研究

The Study of Hysterosalpingography in Diagnosis of the Tubal Patency:Comparision with Laparoscopy and Hysteroscopy

目的探讨高压恒速子宫输卵管造影(hysterosalpingography,HSG)与宫腹腔镜联合检查在诊断输卵管通畅性中的意义。资料与方法回顾性分析36例不孕症患者的HSG资料。均先后行HSG和宫腹腔镜联合探查,间隔时间<1个月。依据诊断标准评价输卵管的通畅性及宫腔、盆腔异常表现。结果 36例共计71支输卵管,HSG通畅30支,阻塞41支,腹腔镜通畅35支,阻塞36支,两者结果一致56支。HSG敏感性为86.1%,特异性为71.4%,阳性似然比3.01,阴性似然比0.19,准确性为78.9%;两组诊断结果比较差异无统计学意义(χ2=0.71,P=0.302),吻合强度差异有统计学意义(k=0.577,P=0.000)。结论 HSG可有效、廉价、快速检查输卵管通畅性,可作为输卵管性不孕检查的首选筛查方法 。

Objective To evaluate the effectiveness of hysterosalpingography（HSG）in the diagnosis of tubal patency,compared with laparoscopy and hysteroscopy results.Materials and Methods In this retrospective study,36 women（age from 22 to 40 years） with a history of at least 1 year of infertility underwent HSG and laparoscopy combined with hysteroscopy.The tubal patency and the abnormal findings of the uterine cavity and pelvic cavity were evaluated.Results Totally 71 oviducts,the numbers of the tubal patency and occlusion were 30,41 showed on HSG,and 35,36 on laparoscopy combined with hysteroscopy.The sensitivity,specificity,accuracy rate,positive likelihood ratio and negative likelihood ratio of HSG were 86.1%,71.4%,78.9%,3.01,0.19,respectively.There was no statistical difference between HSG and laparoscopy combined with hysteroscopy（χ2=0.71,P=0.302）.The coincidence ratio of the two methods was high（k=0.577,P=0.000）.Conclusion HSG is an effective,cheap,rapid imaging technique and shoule be regarded as the screening methods for the infertility due to oviduct occlusion.