子宫输卵管碘造影与超声子宫水造影诊断女性不孕症的临床研究

Clinical study on hysterosalpingography and saline infusion sonohysterography in the diagnosis of female infertility

目的评价子宫输卵管碘造影（HSG）与超声子宫水造影（SIS）对于女性不孕症子宫腔病变的诊断价值。方法选择本院及外院2010年1月∽2014年10月收治的100例女性不孕症患者,同时进行子宫输卵管碘造影与超声子宫水造影,以宫腔镜（HS）和病理结果（Pathol）为指标,探讨两种方法诊断黏膜下肌瘤、宫腔粘连、子宫内膜息肉及子宫腔畸形的敏感性和特异性。结果所有不孕症患者中,90例患者被诊断患有子宫腔病变,HSG、SIS检查诊断为子宫内膜息肉、子宫肌瘤、子宫腔粘连、畸形的符合率分别为73.47%、100.00%、82.14%、90.00%;87.76%、100.00%、92.86%、100.00%;HSG检查诊断为子宫内膜息肉、子宫肌瘤、子宫腔粘连、畸形的敏感性及特异性均优于SIS检查的敏感性及特异性。结论与传统的子宫输卵管碘造影相比,超声子宫水造影对女性不孕子宫腔病变的诊断具有很高的诊断符合率,准确性更高,且SIS诊断的敏感性和特异性较高,操作简便、疼痛轻微、并发症较少,值得进一步推广使用。

Objective To evaluate the diagnostic value of hysterosalpingography（HSG）and saline infusion sonohysterography（SIS）in the diagnosis of uterine cavity disease of female infertility.Methods100 patients with female infertility who were admitted to our and other hospitals from January 2010 to October 2014 were diagnosed by HSG and SIS.Hysteroscopy（HS）and pathological examination（Pathol）were as indexes.Diagnosis of sensitivity and specificity of submucous myoma,intrauterine adhesions,endometrial polyps and uterine cavity malformation were explored with these two methods.Results 90 patients were diagnosed as uterine cavity disease in all patients with infertility.Coincidence rates of HSG and SIS in the examination and diagnosis of endometrial polyps,hysteromyoma,intr auterine adhesions and uterine cavity malformation respectively were 73.47%,100.00%,82.14%,90.00%;87.76%,100.00%, 92.86%,100.00%.Sensitivity and specificity of endometrial polyps,hysteromyoma,intrauterine adhesions and uterine cavity malformation in the HSG＇s examination and diagnosis were all superior to those in the SIS＇s examination and diagnosis.Conclusion SIS has a higher diagnostic accordance rate and it is more accurate in the diagnosis of uterine cavity disease of female infertility compared with traditional HSG.Sensitivity and specificity in the SIS＇s diagnosis are higher.SIS has a simple operation, slight pain and less complications which is worthy of promotion and application.