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1、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对比【摘耍】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（I1SG）检查。以HSG检查为金标准，采用R0C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、
2、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
3、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Applicationeffectoflaparoscopyandhysteroscopj^inthediagnosisandtreatmentoftubalinfertilityLTMingzhul,YANGXiaoqing2.1.DepartmentofObstetricsandGynecology,JinghuaCityWenrongHospital,Jinghua321000,China
4、；2.DepartmentofObstetricsandGynecology,GuangyuanCityMaternalandChildrenHealthHospital，Guangyuan628000,China【Abstract]Objectives：Tocomparetheapplicationeffectsoflaparoscopyandhysteroscopyinthediagnosisandtreatmentoftubalinfertility.Methods:268patientswithsus
5、pectedtubalinfertilityinourhospitalfromJanuary2011toJune2013underwentlaparoscopyandhysteroscopyanduterusoviductimaging(HSG)examination・HSGexaminationresultsweretakenasthegoldstandardandROCcurvewasusedtocomparetheaccuracyoflaparoscopyandhysteroscopyinthediag
6、nosisoftubalinfertility.224patientsdiagnosedastubalinfertilityweredividedintogroupAandgroupBbydigitalrandommethod,112casesineachgroup.GroupAwastreatedbylaparoscopicsurgery,andgroupBadoptedhysteroscopysurgeryfortreatment.Bothgroupsreceived1yearfollow-up.卩ost
7、operativetubal,intrauterinepregnancyrate,ectopicpregnancyrate,andlumenocclusionreoccurrencerateoftwogroupswerecompared.ResuIts：Thesensitivity,specific,accuracy且ndareaunderthecurveoflaparoscopydiagnosingtubalinfertilitywere78.65%,68.48%,85.73%and0.624respect
8、ively,whichwerelessthan92.42%,79.65%，96.54%and0.738ofthehysteroscopydiagnosingtubalinfertility,withstatisticallysignificantdifference(P［Keywords］Laparoscopic；Hysteroscopy；Tubalinfertility；Diagnosis；Tre
