子宫输卵管造影在不孕症诊断中的影像学表现及临床分析

Clinical analysis and imaging findings of hysterosalpingography in diagnosing female infertilitas feminis

目的探讨子宫输卵管造影和腹腔镜检查在诊断女性不孕中的临床价值。方法选取2015年1月—2016年9月本院收治的不孕症患者200例,以腹腔镜检查为标准,进行子宫输卵管造影检查。比较两种检查方法下患者输卵管通畅情况、阻塞部位及不良反应的发生情况,并记录后期1年随访中输卵管性不孕患者的受孕情况。结果腹腔镜检查结果显示,输卵管通畅176条,占46.56%,畅而不通118条,占31.22%,阻塞84条,占22.22%。子宫输卵管超声造影检查结果显示,输卵管通畅164条,符合率是86.36%,通而不畅116条,符合率是72.88%,阻塞98条,符合率是92.86%。子宫输卵管超声造影检查结果总符合率是83.60%。两种检查方法在输卵管的通畅情况、输卵管阻塞部位情况比较中差异无统计学意义(P>0.05),且均未出现严重的不良反应。经子宫输卵管超声造影及腹腔镜诊断后,不孕患者根据诊断结果经积极治疗,1年后患者的妊娠率为92.5%。结论子宫输卵管造影技术对输卵管通畅程度及阻塞部位的诊断明确、安全可靠,在不孕症的诊治及后期临床治疗中具有重要的应用价值。

Objective To explore the clinical significance of hysterosalpingography and laparoscopy in the diagnosis of female infertilitas feminis.Methods A total of200infertility patients treated during Jan.2015and Sep.2016were enrolled.Based on laparoscopy results,hysterosalpingography was performed.The imaging results and1-year follow-up results were analyzed.Results Laparoscopy showed that176(46.56%)fallopian tubes were unobstructed,118(31.22%)were partially obstructed,and84(22.22%)were obstructed.Hysterosalpingography showed164were unobstructed,the coincidence rate being86.36%;116were partially obstructed,the coincidence rate being72.88%;98were obstructed,the coincidence rate being92.86%.The total coincidence rate of hysterosalpingography was83.60%.There was no significant difference between the two methods in detecting tubal patency and tubal obstruction(P>0.05),and there were no serious adverse reactions.The patients5pregnancy rate reached92.5%1year after active treatment.Conclusion Hysterosalpingography can accurately determine the patency of fallopian tubes and the location of obstruction.It is safe and reliable in the diagnosis and treatment of infertility.