Introduction: Fallopian diseases are often implicated in female infertility. Several radiological and surgical explorations have been proposed in order to evaluate the severity of lesions found in utero-adnexal pathol...Introduction: Fallopian diseases are often implicated in female infertility. Several radiological and surgical explorations have been proposed in order to evaluate the severity of lesions found in utero-adnexal pathology. Among tools that are used to investigate such pathologies, we have ultrasound, hysterosalpingography and endoscopy. But, in many developing countries like Cameroon, the usage of endoscopy in gynecology is not yet known by many practicians. The objective of our study was to show the interest of endoscopy in the diagnosis of fallopian tube pathologies. Methodology: We conducted a cross-sectional and descriptive study from March 1<sup>st</sup>, 2017 to May 31<sup>st</sup>, 2017 at the Gyneco-Obstetrics and Pediatric department of our Hospital. We included all women who presented infertility and underwent ultrasound, hysterosalpingography (HSG) and endoscopy at the Yaoundé Gyneco-obstetrics Hospital. We analyzed epidemiological parameters, clinics, ultrasound, hysterosalpingography and endoscopic finding. We used Cohen’s Kappa test to determine the correlation between HSG/endoscopy and ultrasound/endoscopy in the diagnosis of fallopian tube pathologies. The threshold was significant for a K-value > 0.20. Results: We got a sample of 156 women;the mean age was 32.6 ± 4.5 years. The Secondary infertility dominated in 66.7% of cases;31.1% of women presented a past medical history of sexually transmitted infections and 41.7% did abortions before. Endoscopic lesions were dominated by a fallopian obstruction in 54.5% of cases, 8.3% of adhesions, 33.9% of women presented uterine myomas, 37.8% of ovarian cysts and 1.3% of pelvic endometriosis. The K-values between HSG and endoscopy for distal and proximal tube obstructions were significant with respective thresholds of 0.25 and 0.30. The K-value between ultrasound and endoscopy was not significant with a threshold of 0.015 for the tubal hydrosalpinx. Conclusion: Endoscopy assessment appears as the most efficient tool to investigate fallopian tube diseases.展开更多
目的:本研究旨在探讨子宫输卵管四维超声造影在不孕症诊断中的应用价值,并与传统输卵管造影进行比较分析。方法:选取106例不孕症患者作为研究对象,观察组接受子宫输卵管四维超声造影检查,对照组接受传统输卵管造影(X线下输卵管碘油造影...目的:本研究旨在探讨子宫输卵管四维超声造影在不孕症诊断中的应用价值,并与传统输卵管造影进行比较分析。方法:选取106例不孕症患者作为研究对象,观察组接受子宫输卵管四维超声造影检查,对照组接受传统输卵管造影(X线下输卵管碘油造影)检查,观察两组患者诊断灵敏度、特异度、PPV、NPV、输卵管通畅性的检查结果及患者满意度。结果:结果显示,子宫输卵管四维超声造影在灵敏度、特异度、PPV和NPV方面略高于传统造影,差异具有统计学意义(P<0.05);子宫输卵管四维超声造影的患者满意度高于传统造影,差异具有统计学意义(P<0.05)。四维超声造影组的样本量为53,其中通畅的有33例,通而不畅的有11例,阻塞的有9例。传统造影组的样本量也为53,其中通畅的有27例,通而不畅的有13例,阻塞的有13例。在通畅方面,四维超声造影组的通畅率高于传统造影组(33/53 vs. 27/53),且差异具有统计学意义(χ^(2)=5.281,P<0.05);在通而不畅方面,两组之间的差异没有统计学意义(χ^(2)=0.776,P>0.05);在阻塞方面,四维超声造影组的阻塞率低于传统造影组(9/53 vs. 13/53),且差异具有统计学意义(χ^(2)=3.291,P<0.05)。结论:通过对比两组数据,发现子宫输卵管四维超声造影在不孕症诊断中具有准确性、可靠性及与传统方法的比较优势。同时,该方法具有无创性、无辐射、明确的图像显示、多参数评估等优点。因此,子宫输卵管四维超声造影可以作为一种新的不孕症诊断方法,为临床医生提供可靠的诊断依据。其在不孕症治疗中有重要的意义和广阔的前景。展开更多
目的探讨超声造影术在输卵管疾病中的诊断价值。方法对可疑为输卵管原因性不孕症患者40例及输卵管异位妊娠行保守药物治疗后患者36例行子宫输卵管超声造影术(HyCoSy)检查,1周后再行X线碘油造影术(HSG)检查,比较两种检查方法的结果及不...目的探讨超声造影术在输卵管疾病中的诊断价值。方法对可疑为输卵管原因性不孕症患者40例及输卵管异位妊娠行保守药物治疗后患者36例行子宫输卵管超声造影术(HyCoSy)检查,1周后再行X线碘油造影术(HSG)检查,比较两种检查方法的结果及不良反应发生情况。结果 Hy Co Sy在清晰度方面虽不如HSG,但HyCoSy可更直观、多角度的反应输卵管的形态及走行。在不孕症患者输卵管通畅情况检查中,两种方法结果比较,差异无统计学意义(P=0.800);在输卵管异位妊娠术后患者的输卵管通畅情况检查中,两种方法的检查结果的差异亦无统计学意义(P=0.894)。两种方法检查总不良反应发生率比较,经典HSG组(31.5%)明显要高于HyCoSy组(18.4%),差异有统计学意义(P=0.012)。结论 HyCoSy作为一种宫腔输卵管造影方法,其操作安全、简便,检查结果与经典的HSG差异无统计学意义,可直观的观察输卵管的形态、走行,术后不良反应较轻微,可作为临床输卵管通畅情况评价的一种新型、准确、安全的诊断方法,具有较广泛的应用前景。展开更多
文摘Introduction: Fallopian diseases are often implicated in female infertility. Several radiological and surgical explorations have been proposed in order to evaluate the severity of lesions found in utero-adnexal pathology. Among tools that are used to investigate such pathologies, we have ultrasound, hysterosalpingography and endoscopy. But, in many developing countries like Cameroon, the usage of endoscopy in gynecology is not yet known by many practicians. The objective of our study was to show the interest of endoscopy in the diagnosis of fallopian tube pathologies. Methodology: We conducted a cross-sectional and descriptive study from March 1<sup>st</sup>, 2017 to May 31<sup>st</sup>, 2017 at the Gyneco-Obstetrics and Pediatric department of our Hospital. We included all women who presented infertility and underwent ultrasound, hysterosalpingography (HSG) and endoscopy at the Yaoundé Gyneco-obstetrics Hospital. We analyzed epidemiological parameters, clinics, ultrasound, hysterosalpingography and endoscopic finding. We used Cohen’s Kappa test to determine the correlation between HSG/endoscopy and ultrasound/endoscopy in the diagnosis of fallopian tube pathologies. The threshold was significant for a K-value > 0.20. Results: We got a sample of 156 women;the mean age was 32.6 ± 4.5 years. The Secondary infertility dominated in 66.7% of cases;31.1% of women presented a past medical history of sexually transmitted infections and 41.7% did abortions before. Endoscopic lesions were dominated by a fallopian obstruction in 54.5% of cases, 8.3% of adhesions, 33.9% of women presented uterine myomas, 37.8% of ovarian cysts and 1.3% of pelvic endometriosis. The K-values between HSG and endoscopy for distal and proximal tube obstructions were significant with respective thresholds of 0.25 and 0.30. The K-value between ultrasound and endoscopy was not significant with a threshold of 0.015 for the tubal hydrosalpinx. Conclusion: Endoscopy assessment appears as the most efficient tool to investigate fallopian tube diseases.
文摘目的:本研究旨在探讨子宫输卵管四维超声造影在不孕症诊断中的应用价值,并与传统输卵管造影进行比较分析。方法:选取106例不孕症患者作为研究对象,观察组接受子宫输卵管四维超声造影检查,对照组接受传统输卵管造影(X线下输卵管碘油造影)检查,观察两组患者诊断灵敏度、特异度、PPV、NPV、输卵管通畅性的检查结果及患者满意度。结果:结果显示,子宫输卵管四维超声造影在灵敏度、特异度、PPV和NPV方面略高于传统造影,差异具有统计学意义(P<0.05);子宫输卵管四维超声造影的患者满意度高于传统造影,差异具有统计学意义(P<0.05)。四维超声造影组的样本量为53,其中通畅的有33例,通而不畅的有11例,阻塞的有9例。传统造影组的样本量也为53,其中通畅的有27例,通而不畅的有13例,阻塞的有13例。在通畅方面,四维超声造影组的通畅率高于传统造影组(33/53 vs. 27/53),且差异具有统计学意义(χ^(2)=5.281,P<0.05);在通而不畅方面,两组之间的差异没有统计学意义(χ^(2)=0.776,P>0.05);在阻塞方面,四维超声造影组的阻塞率低于传统造影组(9/53 vs. 13/53),且差异具有统计学意义(χ^(2)=3.291,P<0.05)。结论:通过对比两组数据,发现子宫输卵管四维超声造影在不孕症诊断中具有准确性、可靠性及与传统方法的比较优势。同时,该方法具有无创性、无辐射、明确的图像显示、多参数评估等优点。因此,子宫输卵管四维超声造影可以作为一种新的不孕症诊断方法,为临床医生提供可靠的诊断依据。其在不孕症治疗中有重要的意义和广阔的前景。
文摘目的探讨超声造影术在输卵管疾病中的诊断价值。方法对可疑为输卵管原因性不孕症患者40例及输卵管异位妊娠行保守药物治疗后患者36例行子宫输卵管超声造影术(HyCoSy)检查,1周后再行X线碘油造影术(HSG)检查,比较两种检查方法的结果及不良反应发生情况。结果 Hy Co Sy在清晰度方面虽不如HSG,但HyCoSy可更直观、多角度的反应输卵管的形态及走行。在不孕症患者输卵管通畅情况检查中,两种方法结果比较,差异无统计学意义(P=0.800);在输卵管异位妊娠术后患者的输卵管通畅情况检查中,两种方法的检查结果的差异亦无统计学意义(P=0.894)。两种方法检查总不良反应发生率比较,经典HSG组(31.5%)明显要高于HyCoSy组(18.4%),差异有统计学意义(P=0.012)。结论 HyCoSy作为一种宫腔输卵管造影方法,其操作安全、简便,检查结果与经典的HSG差异无统计学意义,可直观的观察输卵管的形态、走行,术后不良反应较轻微,可作为临床输卵管通畅情况评价的一种新型、准确、安全的诊断方法,具有较广泛的应用前景。
