国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
21期
3126-3130
,共5页
子宫输卵管造影术%诊断符合率%假阳性
子宮輸卵管造影術%診斷符閤率%假暘性
자궁수란관조영술%진단부합솔%가양성
Hysterosalpingography%Diagnostic accordance rate%False-positive
目的 分析子宫输卵管造影(HSG)输卵管梗阻假阳性的特征,探讨改进的子宫输卵管造影方法对提高临床诊断符合率、降低假阳性率的作用.方法 选择用常规方法(A组)及改进方法(B组)行HSG的不孕症患者各100例,共400条输卵管,200例中有98例共183条输卵管梗阻,患者均接受宫腹腔镜手术,比较常规方法及改进方法的诊断率及诊断符合率.A组100例共200条输卵管,不作任何处理就造影;B组100例肌肉注射10 mg 654-2后造影,造影采用动态观察,当怀疑有输卵管近端梗阻时,通过加压及牵拉双腔球囊导管再次造影以证实输卵管是否为真的梗阻.结果 A组200条输卵管中,经HSG诊断,通畅95条(47.50％),近端梗阻74条(37.00％),中远端梗阻31条(15.50％);105条HSG诊断为梗阻的输卵管中,腹腔镜诊断为梗阻的75条,诊断符合率为85.0％,假阳性率为21.1％.B组200条输卵管中,经HSG诊断,通畅122条(61.00％),近端梗阻51条(25.50％),中远端梗阻27条(13.50％);78条HSG诊断为梗阻的输卵管中,腹腔镜诊断为梗阻的为71条,诊断符合率为96.50％,假阳性率为5.70％.A组与B组诊断符合率及假阳性率差异均有统计学意义(P＜0.01).结论 术前肌肉注射654-2,造影采用动态观察,当有输卵管梗阻时,通过加压及牵拉双腔球囊导管的方法,可明显提高输卵管梗阻的诊断准确率,降低输卵管梗阻的假阳性率.
目的 分析子宮輸卵管造影(HSG)輸卵管梗阻假暘性的特徵,探討改進的子宮輸卵管造影方法對提高臨床診斷符閤率、降低假暘性率的作用.方法 選擇用常規方法(A組)及改進方法(B組)行HSG的不孕癥患者各100例,共400條輸卵管,200例中有98例共183條輸卵管梗阻,患者均接受宮腹腔鏡手術,比較常規方法及改進方法的診斷率及診斷符閤率.A組100例共200條輸卵管,不作任何處理就造影;B組100例肌肉註射10 mg 654-2後造影,造影採用動態觀察,噹懷疑有輸卵管近耑梗阻時,通過加壓及牽拉雙腔毬囊導管再次造影以證實輸卵管是否為真的梗阻.結果 A組200條輸卵管中,經HSG診斷,通暢95條(47.50％),近耑梗阻74條(37.00％),中遠耑梗阻31條(15.50％);105條HSG診斷為梗阻的輸卵管中,腹腔鏡診斷為梗阻的75條,診斷符閤率為85.0％,假暘性率為21.1％.B組200條輸卵管中,經HSG診斷,通暢122條(61.00％),近耑梗阻51條(25.50％),中遠耑梗阻27條(13.50％);78條HSG診斷為梗阻的輸卵管中,腹腔鏡診斷為梗阻的為71條,診斷符閤率為96.50％,假暘性率為5.70％.A組與B組診斷符閤率及假暘性率差異均有統計學意義(P＜0.01).結論 術前肌肉註射654-2,造影採用動態觀察,噹有輸卵管梗阻時,通過加壓及牽拉雙腔毬囊導管的方法,可明顯提高輸卵管梗阻的診斷準確率,降低輸卵管梗阻的假暘性率.
목적 분석자궁수란관조영(HSG)수란관경조가양성적특정,탐토개진적자궁수란관조영방법대제고림상진단부합솔、강저가양성솔적작용.방법 선택용상규방법(A조)급개진방법(B조)행HSG적불잉증환자각100례,공400조수란관,200례중유98례공183조수란관경조,환자균접수궁복강경수술,비교상규방법급개진방법적진단솔급진단부합솔.A조100례공200조수란관,불작임하처리취조영;B조100례기육주사10 mg 654-2후조영,조영채용동태관찰,당부의유수란관근단경조시,통과가압급견랍쌍강구낭도관재차조영이증실수란관시부위진적경조.결과 A조200조수란관중,경HSG진단,통창95조(47.50％),근단경조74조(37.00％),중원단경조31조(15.50％);105조HSG진단위경조적수란관중,복강경진단위경조적75조,진단부합솔위85.0％,가양성솔위21.1％.B조200조수란관중,경HSG진단,통창122조(61.00％),근단경조51조(25.50％),중원단경조27조(13.50％);78조HSG진단위경조적수란관중,복강경진단위경조적위71조,진단부합솔위96.50％,가양성솔위5.70％.A조여B조진단부합솔급가양성솔차이균유통계학의의(P＜0.01).결론 술전기육주사654-2,조영채용동태관찰,당유수란관경조시,통과가압급견랍쌍강구낭도관적방법,가명현제고수란관경조적진단준학솔,강저수란관경조적가양성솔.
Objective To analyze the imaging features of false-positive results in hysterosalpingography(HSG),and to explore the role of modified HSG in improvement in diagnostic accordance rate reduction in false-positive rate.Methods 200 women undergoing conventional HSG(group A)or modified HSG(group B)were included in this study,with 100 women for each group.98 patients with 183block fallopian tubes received laparoscopic surgery.The diagnostic rate and the diagnostic accordance rate were compared between the two groups.Group A(a total of 200 fallopian tubes)received HSC without contrast;while group B received intramuscular 654-2 of 10mg before HSG.Dynamic observation was applied during angiography.As suspected proximal tubal obstruction occurred,pressure and pulling through double-lumen balloon catheter were applied for repeat HSG.Results Among the 200 tubes of group A,95(47.50％)were unobstructed,and 74(37.00％)obstructed at the near-end and 31(15.50％)obstructed at the mediate-and far-end;of the 105 obstructed tubes,75 were confirmed by laparoscopy,with a diagnostic coincidence rate of 85.00％ and a false positive rate of 21.10％.Among the 200 tubes of group B,122(61.00％)were unobstructed,and 51(25.50％)obstructed at the near-end and 27(13.50％)obstructed at the mediate-and far-end;Among the 78 obstructed ones,71 were confirmed by laparoscopy,with a diagnostic coincidence rate of 96.50％ and a false positive rate of 5.70％.There were differences in diagnostic coincidence rate and false positive rate between group A and B(P＜0.0l).Conclusions Preoperative intramuscular injection of 654-2,contrast dynamic observation,when there is tubal obstruction,pressure and pulling through the double-lumen balloon catheter method is better,can significantly improve the diagnostic accuracy of tubal obstruction,and lower the tubal obstruction of false positive rate.
