子宫输卵管造影不同征象在盆腔粘连性不孕诊断中的价值  

The Value of Different Signs of Hysterosalpingography in the Diagnosis of Infertility Associated With Pelvic Adhension

作　　者：张桂元 蔡名金[1] 魏慧慧 周咪咪 程岑 王芳[2] Zhang Guiyuan;Cai Mingjin;Wei Huihui(Department of Radiology,Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,China)

机构地区：[1]广州医科大学附属第三医院放射科,广州510000 [2]广州医科大学附属第三医院妇产科,广州510000

出　　处：《中国微创外科杂志》2018年第8期711-714,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨子宫输卵管造影(hysterosalpingography,HSG)不同征象在诊断盆腔粘连性不孕中的价值。方法回顾性分析我院2017年1～12月117例女性不孕症行HSG和腹腔镜手术的临床资料。HSG诊断盆腔粘连的征象包括输卵管积水合并伞端碘化油聚集,输卵管壶腹部碘化油残留,盆腔碘化油堆积,输卵管伞端上举。结果 HSG提示盆腔粘连109例,经腹腔镜确诊94例,HSG对盆腔粘连的阳性预测值86.2%(94/109);8例HSG未提示盆腔粘连,腹腔镜下亦未见异常。94例中,HSG只有单一征象41例,合并多个征象53例;输卵管积水合并伞端碘化油集聚单一征象25例;盆腔碘化油堆积合并其他征象45例,输卵管积水合并伞端碘化油集聚合并其他征象39例。结论 HSG依据某些影像特征对盆腔粘连做出初步诊断,其中输卵管积水合并伞端碘化油聚集及盆腔碘化油堆积是最常见的征象。Objective To evaluate the value of different signs of hysterosalpingography（ HSG） in the diagnosis of infertility associated with pelvic adhesion. Methods From January 2017 to December 2017,a total of 117 patients with infertility were examined with HSG and laparoscopy. The signs of HSG to diagnose pelvic adhesions included hydrosalpinx and gather of iodine oil on tube surrounding,oviduct iodine oil residue,spillage of iodine oil into the peritoneal cavity,and vertical fallopian tube. Results There were 109 patients diagnosed as adhesion on HSG,and 94 of those patients had the diagnosis confirmed on laparoscopy. The positive predictive value was 86. 2%（ 94/109）. No adhesion was detected by HSG and no abnormality was found by laparoscopy in 8 cases. Among the 94 patients,41 patients had one radiographic finding alone,and 53 had radiographic finding in combination. The most frequent radiographic findings were hydrosalpinx and gather of iodine oil on tube surrounding and spillage of iodine oil. And 25 patients only presented hydrosalpinx and gather of iodine oil on tube surrounding,45 patients presented as spillage of iodine oil into the peritoneal cavity combined with other radiographic findings,and 39 patients presented as hydrosalpinx and gather of iodine oil on tube surrounding combined with other radiographic findings. Conclusions HSG can detect pelvic adhesions according to some imaging features. The most frequent signs of pelvic adhesion on HSG are the presence of hydrosalpinx and gather of iodine oil on tube surrounding and spillage of iodine oil.

关 键 词：子宫输卵管造影 腹腔镜 盆腔粘连 不孕症 

分 类 号：R711.6[医药卫生—妇产科学]