子宫输卵管造影和宫腔镜诊断宫腔粘连临床对比研究.docVIP

子宫输卵管造影和宫腔镜诊断宫腔粘连临床对比研究 　　【摘要】目的：探索子宫输卵管造影(HSG)检查诊断宫腔粘连(intrauterine adhesion．IUA)与宫腔镜检查诊断的差异，确定HSG检查的可靠性和X线影像特点以及与其他宫腔疾病和鉴别要点。方法：是在HSG检查诊断为IUA后嘱咐病人下一个(或几个)月以后的月经周期月经干净后3~7天来院做宫腔粘镜诊断和治疗，然后对比分析。结果：HSG检查诊断完全性IUA 35例，混合型IUA 30例，宫腔镜检查诊断完全性IUA 35例，混合性IUA30例，两种检查完全吻合。HSG检查诊断周围型IUA 146例，中央型IUA29例，宫腔镜检查周围型IUA 131例，中央型IUA25例，相差共19例，误诊率7．9％，主要是外因影响。结论：HSG检查时间短，对病人痛苦少、安全、简单、经济实惠，其影像资料便于会诊。是目前诊断IUA的首选和重要方法。 　　【关键词】子宫输卵管造影宫腔镜诊治宫腔粘连 　　 　　Utero-salpingography and Uteroscope in the Diagnosis of Intrauterine Adhesions……A Clinical Comparison Study 　　【Abstract】This article discusses the differences between USG and USP in the diagnosis of intrauterine ad-hesions(IUA)．confirming the reliability of using USG on examination，X-ray findings andthe differential diagnosis with other intrauterine diseases．Methods：Patients with intrauterine adhesion detected by USG were informed to have an Uteroscopic examination for further diagnosis and treatment 3-7 days after the next menstruation．Results：1．USG findings manifested：Complete Intrauterine Adhesion(COIUA)35 cases；Mixed Intrauterine Adhesion(MIUA)30 cases．2．USP findings manifested：COIUA 35 cases；MIUA 30 cases．There were no differences between both of the examinations．USG diagnoses：Peripheral Intrauterine Adhesion(PIUA)146 cases；Central Intrauterine Adhesion(CIUA)29 cases．USP diagnoses：PIUA 131 cases；CIUA 25 cases．There was no concordance in 19 cases，between the two sets of results，with a misdiagnosis rate of 7．9%．In conclusion．USG is an up-to-date method that is painless，safe，economical to patients in the diagnosis of IUAs． 　　【Key words】HSGintrauterine adhesion 　　 　　宫腔粘连(intrauterine adhesion．IUA)也称阿谢曼综合征(Asherman syndrome)，由Asherman1948年首报。常见于人工流产术与刮宫术后的一种远期并发症，也是宫腔镜电切术后的???期主要严重并发症。本文收集我科和省妇幼保健院放射科近三年来子宫输卵管造影(HUG)诊断为IUA240例嘱咐病人在1~6个月内行宫腔镜检查并诊治，对其结果进行对比研究，现报道如下。 　　 　　1资料与方法 　　 　　1．1临床资料:本组240例IUA患者均因闭经和不孕来院就诊，是在HSG检查2万例不孕症患者中发现，约占不孕症患者中的1．2％，诊断为宫腔结核和其它原因未行宫腔镜检查未例入其中。原发不孕15例(6．2％)，继发不孕186例(93．8％)。年龄19-45岁，以24-35岁居多。追问病史发现，10例(4．1％)顺