子宫输卵管碘油造影诊断输卵管性不孕的局限性研究

目的 与腹腔镜下通液检查对照,研究子宫输卵管碘油造影（HSG）诊断输卵管性不孕的诊断价值及局限性.方法 选择2005年1月至2009年12月在中山大学孙逸仙纪念医院因HSG发现输卵管病变行腹腔镜检查的167例不孕症患者,共计330条输卵管,以手术中所见为诊断标准,对两种检查方法结果进行回顾性分析.结果 两种检查方法差异有统计学意义,HSG诊断输卵管通畅的阳性符合率（敏感度）为55.0%,诊断通而不畅的符合率为18.5%,诊断阻塞的阴性符合率（特异度）为84.4%,判断输卵管通畅性的准确性是71.8%,167例患者中148例腹腔镜检查存在不同程度的盆腔粘连,HSG发现30例.结论 HSG是判断输卵管通畅性有效的方法,但有其局限性,对HSG提示输卵管病变,特别是提示通而不畅及盆腔粘连者,应及时行腹腔镜检查及治疗.

Investigating on the diagnostic limitations of hysterosalpingography in tubal infertility

Objectve To compared the standard diagnostic laparoscopy with the chromopertubation test, this study investigated the diagnostic value and its diagnostic of hysterosalpingography(HSG)in the assesment of tubal patency. Methods Form Jan.2005 to Dec.2009, 167 infertile patients in Sun Yat-sen Memorial Hospitalof Sun Yat-sen University were recruited, who had tubal diseases detected by hysterosalpingography and then received laparoscopic tubal re-examination.330 fallopian tubes were examined totally, the results of laparoscopy and hysterosalpingography for tubal patency assessment were compared retrospectively. Results There were statistical difference between the two methods. The positive coincidence rate (sensitivity) of HSG for detecting tubal patency was 55.0%, the diagnostic accordance rate of incompletely unobstructed tubes was 18.5%, and the negative consistent (specificity) of obstructed tubes was 84.4%. And the diagnostic accuracy was 71.8%. 148 Patients who had pelvic adhesion were detected by laparoscopy, however, only 30 cases of pelvic adhesion were detected by HSG. Conclusion HSG was an effective method for assessing tubal patency initially, but it had its own deficiency, it is necessary to make a diagnosis and give treatment under laparoscopy when tubal diseases were detected by HSG, especially when tubes were found to be incompletely unobstructed and the patients may have pelvic adhesion.