子宫输卵管碘油造影和腹腔镜检查对盆腔粘连不孕的临床意义

目的观察子宫输卵管碘油造影和腹腔镜检查对盆腔粘连不孕的诊治效果。方法不孕症患者176例，其中无粘连组41例，输卵管75条；轻度粘连组，共46例，输卵管8l条；中度粘连组，共44例，输卵管77条；重度粘连组，共45例，输卵管82条；分别接受子宫输卵管碘油造影和腹腔镜检查。结果315条输卵管经子宫输卵管碘油造影与腹腔镜检查，两者均诊断为通畅的总体符合率为71．3％，两者均诊断为不通的符合率为56．1％。随着盆腔粘连程度的加剧，子宫输卵管碘油造影诊断通畅的符合率呈逐渐下降，依次为93．5％、83．O％、38．7％和25．O％，诊断为不通的符合率呈逐渐上升，依次为16．7％、20．8％、58．3％和80．3％，但各组符合率比较，差异无统计学意义（P〉0．05）。子宫输卵管碘油造影显示形态不佳，伞端粘连输卵管与腹腔镜检查的符合率为73．9％；子宫输卵管碘油造影显示积水的输卵管与腹腔镜检查结果符合率为71．4％。结论子宫输卵管碘油造影与腹腔镜检查具有较高的符合度，可作为筛查女性不孕患者输卵管通畅性的首选方法，同时为腹腔镜检查提供较可靠的依据，以减少患者的痛苦，提高诊断效率。

Clinical significance of hysterosalpingography and laparoscopy in diagnosis and treatment of pelvic adhesions infertility

Objective To observe the effect of hysterosalpingography and laparoscopy in diagnosis and treat- ment of pelvic adhesions infertility. Methods 176 infertility patients were classified into non-adhesions group（41 cases） with 75 fallopian tubes, mild adhesions group （46 cases） with 81 fallopian tubes, moderate adhesion group （44 cases ） with 77 fallopian tubes, and severe adhesions group （45 cases） with 82 fallopian tubes. They received hystero- salpingography and laparoscopy examination. Results 315 fallopian tubes detected by hysterosalpingography and lap- aroscopy, the overall coincidence rate of diagnosed as smooth was 71.3 %, the coincidence rate of diagnosed as unrea- sonable was 56.1%. With the increasing degree of pelvic adhesions, diagnostic coincidence rate of patency hysterosal- pingography was gradually decreased,followed by 93.5% ,83.0% ,38.7% and 25.0%, the coincidence rate of diag- nosed as unreasonable was gradually increased, followed by 16.7% ,20.8% ,58.3% and 80.3% , but had no signifi- cant differenees（P 〉0.05 ）. Hysterosalpingography showed poor morphology, the coincidence rate of adhesion tubal fimbria with laparoscopy was 73.9%. The coincidence rate of hydrocephalus laparoscopic tubal results was 71.4%. Conclusion Hysterosalpingography and laparoscopy has high degree of compliance, can be used as the preferred screening method for female infertility patients of tubal patency, as well as provide more reliable basis for laparoscopy to reduce the suffering of patients, improve the diagnosis efficiency.