子宫输卵管造影和宫腹腔镜联合诊断女性不孕症118例分析

目的探讨子宫输卵管造影(hysterosalpingography,HSG)和宫腹腔镜联合手术在诊断女性不孕症中的价值。方法对118例女性不孕症患者先后行子宫输卵管碘海醇造影和宫腹腔镜手术和分析。结果 HSG与宫腹腔镜手术诊断输卵管阻塞无统计学意义(P>0.05),HSG诊断输卵管阻塞的敏感度为82.54%,特异度为60.74%;HSG时75例患者盆腔未显影,腹腔镜发现其中42例有盆腔粘连,HSG、腹腔镜对显影的43例患者诊断盆腔粘连无统计学意义(P>0.05),HSG诊断盆腔粘连的敏感度为40.91%,特异性为52.38%;对宫腔病变的检出率HSG和宫腔镜分别为7.63%、50.85%(P<0.05)。结论 HSG对输卵管阻塞有较好的诊断价值,对盆腔粘连的诊断价值有限,对宫腔病变的诊断远不及宫腔镜。

Clinical anlysis of 118 cases of female infertility diagnosed by hysterosalpingography and hysteroscopy combined with laparoscopy

Objective To investigate the value of diagnosis of female infertility by hysterosalpingography(HSG) and hysteroscopy combined with laparoscopy(H-laparoscopy).Methods 118 cases of female infertility were performed by HSG and H-laparoscopy,the results were analyzed.Results There were no significant difference in diagnosis of fallopian tubal obstruction by HSG and H-laparoscopy(P>0.05),the sensitivity of HSG was 82.54%,specificity was 60.74%.The pelvic of 75 cases were undeveloped by HSG,while 42 cases of them were founded adhesions by hysteroscopy.There were no significant difference in diagnosis of pelvic adhesions by HSG and H-laparoscopy(P>0.05),the sensitivity of HSG was 40.91%,specificity was 52.38%.The detection rate of intrauterine lesions by HSG and H-hysteroscopy were 7.63% and 50.85%(P<0.05).Conclusion HSG has better diagnostic value for fallopian tube obstruction and limited diagnostic value for pelvic adhesions in the study of infertility.HSG is unattainable in the diagnosis of intrauterine lesions than hysteroscopy.