腹腔镜和宫腔镜在输卵管性不孕诊断和治疗中应用效果对比.docVIP

腹腔镜和宫腔镜在输卵管性不孕诊断和治疗中应用效果对比 　　【摘要】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（P0.05）。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。 　　【关键词】腹腔镜；宫腔镜；输卵管性不孕；诊断；治疗 　　Application effect of laparoscopy and hysteroscopy in the diagnosis and treatment of tubal infertilityLI Mingzhu1， YANG Xiaoqing2. 1. Department of Obstetrics and Gynecology， Jinghua City Wenrong Hospital， Jinghua 321000， China； 2. Department of Obstetrics and Gynecology， Guangyuan City Maternal and Children Health Hospital， Guangyuan 628000， China 　　【Abstract】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 surgery， and group B adopted hysteroscopy surgery for treatment. Both groups received 1 year follow-up. Postoperative 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