中国性科学
中國性科學
중국성과학
Chinese Journal of Human Sexuality
2015年
9期
86-88
,共3页
腹腔镜%宫腔镜%输卵管性不孕%诊断%治疗
腹腔鏡%宮腔鏡%輸卵管性不孕%診斷%治療
복강경%궁강경%수란관성불잉%진단%치료
Laparoscopic%Hysteroscopy%Tubal infertility%Diagnosis%Treatment
目的：比较腹腔镜和宫腔镜在输卵管性不孕诊断和治疗中的应用效果。方法：对2011年1月至2013年6月期间我院收治的疑为输卵管性不孕患者268例先后进行腹腔镜、宫腔镜和子宫输卵管造影（HSG）检查。以 HSG 检查为金标准，采用 ROC 曲线比较腹腔镜、宫腔镜诊断输卵管性不孕的准确性。将确诊的224例患者按数字随机法分为 A 组和 B 组，每组112例，A 组采用腹腔镜手术治疗，B 组采用宫腔镜手术进行治疗，两组均进行1年的随访，比较两组术后输卵管再通率、宫内妊娠率、异位妊娠率、管腔再闭塞率。结果：腹腔镜诊断输卵管性不孕的灵敏性、特异度、准确性和曲线下面积分别为78.65％、68.48％、85.73％和0.624，低于宫腔镜的92.42％、79.65％、96.54％和0.738，差异有统计学意义（P ＜0.05）。A 组术后术输卵管再通率、随访期间宫内妊娠率分别为31.25％和32.14％，均低于 B 组的44.64％和46.43％，A 组术后和随访期间异位妊娠率、管腔再闭塞率则高于 B 组，差异有统计学意义（P ＜0.05）。结论：宫腔镜诊断输卵管性不孕更准确，宫腔镜手术可提高患者术后输卵管再通率、宫内妊娠率，预防管腔再闭塞的发生，值得临床推广使用。
目的：比較腹腔鏡和宮腔鏡在輸卵管性不孕診斷和治療中的應用效果。方法：對2011年1月至2013年6月期間我院收治的疑為輸卵管性不孕患者268例先後進行腹腔鏡、宮腔鏡和子宮輸卵管造影（HSG）檢查。以 HSG 檢查為金標準，採用 ROC 麯線比較腹腔鏡、宮腔鏡診斷輸卵管性不孕的準確性。將確診的224例患者按數字隨機法分為 A 組和 B 組，每組112例，A 組採用腹腔鏡手術治療，B 組採用宮腔鏡手術進行治療，兩組均進行1年的隨訪，比較兩組術後輸卵管再通率、宮內妊娠率、異位妊娠率、管腔再閉塞率。結果：腹腔鏡診斷輸卵管性不孕的靈敏性、特異度、準確性和麯線下麵積分彆為78.65％、68.48％、85.73％和0.624，低于宮腔鏡的92.42％、79.65％、96.54％和0.738，差異有統計學意義（P ＜0.05）。A 組術後術輸卵管再通率、隨訪期間宮內妊娠率分彆為31.25％和32.14％，均低于 B 組的44.64％和46.43％，A 組術後和隨訪期間異位妊娠率、管腔再閉塞率則高于 B 組，差異有統計學意義（P ＜0.05）。結論：宮腔鏡診斷輸卵管性不孕更準確，宮腔鏡手術可提高患者術後輸卵管再通率、宮內妊娠率，預防管腔再閉塞的髮生，值得臨床推廣使用。
목적：비교복강경화궁강경재수란관성불잉진단화치료중적응용효과。방법：대2011년1월지2013년6월기간아원수치적의위수란관성불잉환자268례선후진행복강경、궁강경화자궁수란관조영（HSG）검사。이 HSG 검사위금표준，채용 ROC 곡선비교복강경、궁강경진단수란관성불잉적준학성。장학진적224례환자안수자수궤법분위 A 조화 B 조，매조112례，A 조채용복강경수술치료，B 조채용궁강경수술진행치료，량조균진행1년적수방，비교량조술후수란관재통솔、궁내임신솔、이위임신솔、관강재폐새솔。결과：복강경진단수란관성불잉적령민성、특이도、준학성화곡선하면적분별위78.65％、68.48％、85.73％화0.624，저우궁강경적92.42％、79.65％、96.54％화0.738，차이유통계학의의（P ＜0.05）。A 조술후술수란관재통솔、수방기간궁내임신솔분별위31.25％화32.14％，균저우 B 조적44.64％화46.43％，A 조술후화수방기간이위임신솔、관강재폐새솔칙고우 B 조，차이유통계학의의（P ＜0.05）。결론：궁강경진단수란관성불잉경준학，궁강경수술가제고환자술후수란관재통솔、궁내임신솔，예방관강재폐새적발생，치득림상추엄사용。
Objectives:To compare the application effects of laparoscopy and hysteroscopy in the diagnosis and treatment of tubal infertility.Methods:268 patients with suspected tubal infertility in our hospital from January 2011 to June 2013 underwent laparoscopy and hysteroscopy and uterus oviduct imaging (HSG)examination.HSG examination results were taken as the gold standard and ROC curve was used to compare the accuracy of laparoscopy and hysteroscopy in the diagnosis of tubal infertility.224 patients diagnosed as tubal infertility were divided into group A and group B by digital random method,112 cases in each group.Group A was treated by laparoscopic sur-gery,and group B adopted hysteroscopy surgery for treatment.Both groups received 1 year follow -up.Postopera-tive tubal,intrauterine pregnancy rate,ectopic pregnancy rate,and lumen occlusion reoccurrence rate of two groups were compared.Results:The sensitivity,specific,accuracy and area under the curve of laparoscopy diagnosing tubal infertility were 78.65%,68.48%,85.73% and 0.624 respectively,which were less than 92.42%,79. 65%,96.54% and 0.738 of the hysteroscopy diagnosing tubal infertility,with statistically significant difference (P<0.05).The postoperative oviduct recanalization rate and intrauterine pregnancy rate in the follow -up of group A were 31.25% and 32.14% respectively,which were lower than group B of 44.64% and 46.43% respectively;In the postoperative follow -up period,the ectopic pregnancy rate and lumen occlusion rate of group A were higher than those of group B,with statistically significant difference (P <0.05).Conclusions:Hysteroscopy can accu-rately diagnose tubal infertility,and hysteroscopy surgery can improve the oviduct recanalization rate and intrauterine pregnancy rate while prevent the recurrence of lumen and occlusion.
