输卵管通液与子宫输卵管造影在输卵管通畅性诊断中的对比研究

Comparison of value of hydrotubation and hysterosalpingography in diagnosis of tubal patency

目的对比分析输卵管性不孕患者行输卵管通液、或/和输卵管造影(HSG)两种术前输卵管通畅性检查方法的临床应用价值。方法选取输卵管性不孕患者545例分别行输卵管通液术和/或子宫输卵管造影,并行腹腔镜检查,统计术前检查结果与腹腔镜检查的符合率。结果术前行输卵管通液患者181例,经腹腔镜探查,输卵管通畅的诊断符合率为60.0%,输卵管不通的诊断符合率为57.9%。术前行输卵管造影患者492例,总的输卵管通畅(左+右)的诊断符合率为74.8%,输卵管阻塞(左+右)的诊断符合率为74.6%,其结果与输卵管通液相比差异有统计学意义(P<0.01);其中输卵管造影对输卵管左侧、右侧近端阻塞诊断符合率分别为58.4%、57.3%,左侧、右侧远端阻塞诊断符合率则明显高于近端,分别为88.3%、79.0%,差异有统计学意义(P<0.01)。结论在目前常用的术前检查输卵管通畅性的方法中,输卵管造影比输卵管通液的准确率高,且信息量更多,是一种有价值、简单无创的检查方法。

Objective To compare and analyze the clinical application value of hydrotubation and hysterosalpingography for tubal pa- tency in patients with tubal infertility. Methods A total of 545 patients with tubal infertility underwent hydrotubation and/or hysterosalpin- gography, respectively, laparoscopy was performed, the coincidence rate of preoperative examination results and laparoscopy were calculated. Results A total of 181 patients underwent hydrotubation and laparoscopy, the diagnostic coincidence rates of tubal patency and tubal ob- struction were 60. 0% and 57. 9%, respectively. A total of 492 patients underwent hysterosalpingography and laparoscopy, the total diagnos- tic coincidence rates of tubal patency （left＋right） and tubal obstruction （left＋right） were 74. 8% and 74.6%, respectively, compared with hydrotubation, there were statistically significant differences （P〈0. 01 ） . The diagnostic coincidence rates of hysterosalpingography for left side and right side proximal tubal obstruction were 58.4% and 57. 3% , respectively. The diagnostic coincidence rates for left side and right side distal tubal obstruction were 88. 3% and 79. 0%, respectively, which were statistically significantly higher than those for left side and right side proximal tubal obstruction （P〈0. 01 ） . Conclusion At present, the accurate rate of hysterosalpingography is higher than that of hydrotubation among the preoperative examination methods of tubal patency, hysterosalpingography can indicate more information, which is a valuable, simple, and noninvasive examination method.