输卵管宫腔镜通液术与碘油造影通畅度临床应用价值比较研究

A comparision between tubal patency diagnosis and hysteroscopic hydrotubation accompanied by B-type ultrasound and hysterography

目的探讨超声辅助下的宫腔镜输卵管通液术与子宫输卵管碘油造影(hysterosalpinography,HSG)在评价输卵管通畅度中的临床应用价值。方法对265例不孕症患者行超声辅助下的宫腔镜输卵管通液术,观察液体反流及盆腔积液改变情况。全部患者术前均在三级甲等医院做过HSG并附有诊断报告,比较宫腔镜通液与HSG诊断的符合率。结果 HSG和超声辅助下的宫腔镜输卵管通液两者符合率81.9%(434/530),其中两者均诊断输卵管不通204条,通畅216条,通而不畅14条,两者诊断输卵管通畅度的一致性一般(Kappa=0.69,P=0.03)。结论超声辅助下的宫腔镜输卵管通液检查和HSG在诊断输卵管通畅度方面各有所长,临床中应根据患者的病情选择不同的检查方法。

Objective To compare the clinical value of hysteroscopic hydrotubation accompanied by B-type ultrasound and HSG in the diagnosis of tubal patency.Methods 265 infertile patients between Jan 2008 and Jan 2009 underwent hysteroscopic hydrotubation.Preoperative hysterosalpingography was performed routinely in hospitals of Grade Three.Their evaluation of the patency of the fallopian tube was compared.Results Hysterosalpingography and hysteroscopic hydrotubation both found 204 tubes blocked,216 tubes open,14 tubes open but not clear,both with an accuracy of 81.8%（434/530）.The diagnosis was consistent between the two methods（Kappa=0.69,P=0.03）.Conclusion Both hysteroscopic catheter hydrotubation accompanied by B-type ultrasound and HSG have their own advantages in tubal patency diagnosis.Methods used should vary according to patients and conditions.