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子宫输卵管实时三维超声造影与腹腔镜通染液检查评价输卵管通畅性的对比研究
作者:阚晓纯1  白伟伟1  张卫红2  徐建群2  孙红光3 
单位:1. 无锡市锡山人民医院 超声科, 江苏 无锡 214011;
2. 无锡市锡山人民医院 妇科, 江苏 无锡 214011;
3. 扬州大学附属医院 超声科, 江苏 扬州 225001
关键词:子宫输卵管实时三维超声造影 输卵管通畅性 腹腔镜 不孕症 
分类号:R711.61
出版年·卷·期(页码):2018·46·第五期(541-545)
摘要:

目的:探讨子宫输卵管实时三维超声造影评价输卵管通畅性的临床效果和应用价值。方法:选择2015年6月至2017年10月在无锡市锡山人民医院治疗的54例不孕症患者,分别进行子宫输卵管实时三维超声造影和腹腔镜通染液检查,分析两种检查方法符合率、敏感度和特异度。结果:54例患者共有输卵管102条(其中6例患者有单侧输卵管切除病史)。实时三维超声造影结果显示输卵管有21条通畅,34条通而不畅,47条阻塞。行腹腔镜下通染液检查结果显示输卵管有19条通畅,32条通而不畅,51条阻塞。采用腹腔镜下通染液检查的结果为判断标准,子宫输卵管实时三维超声造影在输卵管通畅性诊断中的敏感性和特异性分别为91.84%和96.08%,阳性预测值和阴性预测值分别为95.74%和89.09%。102条输卵管实时三维超声造影与腹腔镜通染液检查的结果具有较高的吻合度(Kappa=0.843 2,P<0.05)。结论:子宫输卵管实时三维超声造影与腹腔镜通染液检查在不孕症患者中应用于输卵管通畅性的诊断结果一致性较好,是一种临床诊断不孕症切实可行的方法。

Objective: Using real-time three-dimensional Hysterosalpingo-contrast sonography(3D-HyCoSy) and laparoscopy examination to compare and study the patency of fallopian tube and to explore the clinical effect and application value for tubal patency evaluation.Methods: A total of 54 infertile patients treated in our hospital from June 2015 to October 2017 were selected. All of them took real-time 3D-HyCoSy and laparoscopy examination. The diagnostic coincidence rate, sensitivity and specificity were compared between the two groups.Results: For all 102 fallopian tubes in 54 patients(6 patients had a history of unilateral salpingectomy), real-time 3D-HyCoSy showed 21 unobstructed tubes, 34 partially passable and 47 obstructed tubes, while laparoscopy examination showed 19 unobstructed tubes, 32 partially passable and 51 obstructed tubes. The results of laparoscopic examination was taken asthe judgment standard, the sensitivity, specificity of real-time 3D-HyCoSy for diagnosis of fallopian tubal patency was 91.84%,96.08%, while positive predictive value and negative predictive value was 95.74%,89.09%.102 fallopian tubes were checked by both real-time 3D-HyCoSy and laparoscopy. The results show that the two methods had a good consistency(Kappa=0.843 2, P <0.05).Conclusion: Real-time 3D-HyCoSy and laparoscopy have good consistency in assessing fallopian tube patency for infertile female patients, which is a feasible method of clinical diagnosis for infertility.

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