子宫输卵管造影在输卵管性不孕中的诊断价值

Analysis on the diagnostic value of hysterosalpingography for tubal infertility

目的分析子宫输卵管造影(HSG)在输卵管性不孕中的诊断价值。方法选取2011年1月-2015年4月在该院生殖中心门诊就诊的不孕患者105例,分别行HSG检测和腹腔镜下输卵管通液检查,以术中诊断结果为金标准,分别评估两种诊断方法对输卵管性不孕的诊断价值。结果纳入本研究的输卵管207条,其中51条为通畅,23条通而不畅,81条为远端阻塞,41条输卵管积水,11条近端阻塞;HSG对输卵管性不孕诊断的敏感性、准确度以及特异性分别为0.921、0.884和0.871;腹腔镜检查对输卵管性不孕诊断的敏感性、准确度以及特异性分别为0.843、0.889和0.904。Kappa分析结果表明,两种诊断方法与术中诊断结果均具有较好的一致性。结论 HSG与腹腔镜检查输卵管性不孕的临床诊断价值没有明显差异,两种诊断方法均可在临床推广应用。

Objective To analyze the diagnostic value of hysterosalpingography（ HSG） for tubal infertility. Methods A total of105 patients with infertility treated in outpatient of reproductive center in the hospital from January 2011 to April 2015 were selected,HSG and laparoscopic tubal patent test were performed respectively,the intraoperative diagnostic result was taken as gold standard,the diagnostic value of the two methods for tubal infertility was evaluated. Results A total of 207 fallopian tubes were included in this study,51 fallopian tubes were unobstructed,23 fallopian tubes were passable,81 fallopian tubes were diagnosed as distal obstruction,41 fallopian tubes were diagnosed as hydrosalpinx,and 11 fallopian tubes were diagnosed as proximal obstruction. The sensitivity,accuracy and specificity of HSG in diagnosis of tubal infertility were 0. 921,0. 884,and 0. 871,respectively; the sensitivity,accuracy and specificity of laparoscopy in diagnosis of tubal infertility were 0. 843,0. 889,and 0. 904. Kappa analysis results showed that both of the two diagnostic methods were in good agreement with gold standard. Conclusion The clinical diagnostic value of HSG and laparoscopy for tubal infertility is similar,both of the two methods can be promoted and applied in clinic.