输卵管影像学分级与腹腔镜下输卵管评级的对照研究  

The comparison study on diagnosis of the grading of fallopian tube by imageology and laparoscopy

作　　者：张雄军[1] 邓志春[1] 陈晋[2] 张文悫[2] 何云峰[1] 柏魏[1] 

机构地区：[1]玉溪市人民医院介入室,云南玉溪653100 [2]玉溪市人民医院妇产科,云南玉溪653100

出　　处：《云南医药》2009年第6期619-622,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的探讨输卵管性不孕的影像学分级与腹腔镜下输卵管状态评级的诊断一致性。方法回顾性分析109例经子宫输卵管碘油造影(HSG)后行腹腔镜检查的病例。依据输卵管造影的形态、积水程度、碘油留置输卵管内及进入盆腔后的弥散情况将输卵管造影的影像分为5级(级别越高,病变程度越重),并与腹腔镜下输卵管评级进行一致检验。结果211条输卵管的影像学分级与腹腔镜下输卵管状态评级具有较好的一致性(左侧Kappa=0.923,右侧Kappa=0.884,P<0.05)。10例经HSG分级诊断为输卵管近端阻塞的病例,经腹腔镜下评级为低级别。结论输卵管影像学分级能很好的判断输卵管的病变程度,特别是对于近端阻塞者。对输卵管性不孕的患者,应进行输卵管影像学分级,根据分级指导其治疗方法的选择。Objective To investigate the consistency of diagnosis for the grading of fallopian tube by imageology and laparoscopy. Methods 109 infertile women who underwent the hysterosalpingography （HSG） and laparoscopy from January 2005 to December 2008 were analyzed retrospectively. Their tubes were classified into five grades with imageology according to the shapes of salpingian obstruction, the stagnation of lipiodol in salpinx ,and the information of diffusion by lipiodol entering into pelvic cavity through salpinx. The degrees of the oviduct were classified into four grades with laparoscopy according to the degree of the oviduct patency, the macroscopic aspect of endosalpinx, the thickness of the tubal wall, the nature and extent of adhesions and other complications. The higher the grading was, the worse lesion the salpinx was. The correlation of two types of grading between imageology and laparoscopy were analyzed. Results Of 211 cases diagnosed as occlusion tubes by HSG, 85 of them were classified into low grading and 126 cases were into high grading. All of them were confirmed by laparoscopy, and the low grading of laparoscopy was of 95 cases, the high grading was of 116 cases. There was almost coincidence of diagnosis for the grading of fallopian tabe by imageology and laparoscopy （the left Kappa = 0.923, the right Kappa = 0.884, P〈0.05）. 10 of 211 cases were diagnosed of proximate occlusion by HSG, but these cases were diagnosed proximate normal by lapsroscopy.Conclusion The grading of fallopian tube by HSG can be used as the first step to diagnose the tube occlusion precisely, especially to diagnose the proximate occlusion and inner wall of tubal lesion ,and can help doctors to make the right treatment for infertility.

关 键 词：放射摄影术 腹腔镜 输卵管 不孕症 

分 类 号：R713.5[医药卫生—妇产科学]