子宫输卵管造影在不育患者中诊断输卵管通畅程度的临床价值  

The value of hysterosalpingography in the diagnosis of tubal pathology in infertile patients

作　　者：王辉[1] 林仙华[1] 诸溢扬[1] 陈姝[1] 吴为玲[1] 

机构地区：[1]浙江省台州医院恩泽妇产医院妇产科,台州318000

出　　处：《生殖医学杂志》2010年第5期399-401,共3页Journal of Reproductive Medicine

摘　　要：目的探讨子宫输卵管造影(HSG)诊断输卵管病理的准确性及临床应用价值。方法选择我院2009年7～12月不育患者119例,采用HSG和腹腔镜两种方法检查输卵管237支,交叉分析二者检查输卵管病理改变的结果,评价HSG的临床应用价值。结果 HSG的总符合率为73.0%,灵敏度为93.4%,特异度为45.0%,阳性似然比1.7,阴性似然比0.1;其中造影检查提示输卵管通畅的灵敏度和特异度分别为45.0%和93.0%,阳性似然比6.4,阴性似然比0.6;输卵管积水的灵敏度和特异度分别为85.4%和76.3%,阳性似然比3.6,阴性似然比0.2;输卵管不通的灵敏度和特异度分别为43.5%和65.2%,阳性似然比1.3,阴性似然比0.9;通而不畅的灵敏度和特异度分别为56.0%和42.0%,阳性似然比1.0,阴性似然比0.9。结论 HSG检查输卵管积水的准确性良好,输卵管通畅的特异性较高;对输卵管不通畅或者通而不畅的患者需进一步腹腔镜检查。Objective： To evaluate the sensitivity and accuracy of hysterosalpingography in the diagnosis of tubal pathology among infertile patients. Methods： One hundred and nineteen patients with various kinds of infertility factors our hospital from July to December, 2009. A total of 237 fallopian tubes were examined salpingography and laparoscopy and the results were compared. were recruited in by both hystero Results： With laparoscopy as control, the coincidence rate of hysterosalpingography was 73.0%. The sensitivity of 93.4%, specificity of 45.0%, positive likelihood ratio of 1.7 and negative likelihood ratio of O. 1 for hysterosalpingography in evaluating general tubal pathology were calculated. In evaluating tubal patency, hysterosalpingography showed the sensitivity of 45.0 %, specificity of 93.0 %, positive likelihood ratio of 6.6 and negative likelihood ratio of 0.6, while in identifying tubal hydrosalpinx, the sensitivity, specificity, positive and negative likelihood ratios were 85.4%, 76.3% ,3.6 and 0.2, respectively. When tubal occlusion was defined, the sensitivity of 43.5~, specificity of 65.2%, positive likelihood ratio of 1.3 and negative likelihood of 0.9 were calculated. As a test for the unobstructed but impeded tubes, hys- terosalpingography had sensitivity of 56.0%, specificity of 42.0%, positive likelihood ratio of 1.0 and negative likelihood ratio of 0.9. Conclusions： Hysterosalpingography is accurate in diagnosis of tubal hydrosalpinx and specific in iden- tification of tubal patency, while weak in evaluation of general tubal pathology and peritubal adhesions. Laparoscopy is needed to confirm tubal occlusion or the unobstructed but impeded tubes.

关 键 词：子宫输卵管造影 不育 似然比 腹腔镜检查 

分 类 号：R[医药卫生]