经阴道超声输卵管显影与腹腔镜检查的对照研究

目的 :通过与腹腔镜检查的比较 ,评价经阴道超声输卵管显影对输卵管病变的诊断价值。　方法 :对 5 2例原发性或继发性不孕症病人的 10 4根输卵管在生理盐水和空气的介导下进行经阴道超声输卵管显影的检查 ,继之作腹腔镜检查并以美蓝作输卵管通色素试验 ,二者的结果作kappa分析。　 结果 :对输卵管伞端形态异常 ,2种方法的诊断符合率为 82 .7% ,超声输卵管显影的灵敏度和特异度分别为 77.4 %和 87.2 % ;对输卵管周围粘连 ,符合率为 80 .8%。灵敏度和特异度分别为 79.4 %和 83 .0 % ;对输卵管通畅性的诊断 ,3项指标分别为 87.5 % ,87.7%和 87.0 %。超声输卵管显影对输卵管病变的诊断价值与腹腔镜检查无显著性差异。　结论 :经阴道超声输卵管造影是一种可靠实用的检查方法 ,可作为不孕症初步诊断中首选方法。

Comparative Study of Transvaginal Sonosalpingography with Laparoscopy

Objectives: To evaluate the value of transvaginal sonosalpingography in diagnosis of tubal pathology comparied with laparoscopy. Methods: Fifty two patients (104 tubes) suffered from primary or secondary stertility were examined with transvaginal sonosalpingography,using saline solution and air as a contrast medium. The results were compared with the findings at laparoscopy and chromotubation with Methylwne blue solution. Results: In diagnosing abnormality of tubal fimbria ,the findings of both methods agreed in 89 out of 104 tubes (concordance,82.7%) .The sensitivity and specificity of sonosalpingography were 77.4% and 87.2%,respectively.In the adhesion around the fallopian tube,the concordance was 80.8%. The sensitivity was 79.4% and the specificity 83.0%. The concordance ,sensitivity and specificity in diagnosing tubal patency was 87.5%,87.7% and 87.0%,respectively.There was no significant difference in the assessment of tubal pathology between sonosalpingography and laparoscopy. Conclusions: Transvaginal sonosalpingography (TSSG) is a reliable examination method, which can be used as a first selected of tubal pathology for the primary investigation of infertility .