探讨子宫输卵管超声造影（HyCoSy）联合盆腔水造影在输卵管通畅性及伞端评估中的应用价值。

选取2018年4月至2019年2月在浙江省人民医院行HyCoSy及盆腔水造影检查，诊断为一侧或双侧输卵管伞端阻塞或盆腔粘连导致伞端部分阻塞的患者72例，所有患者均于造影后6个月内行腹腔镜下输卵管通液手术。以腹腔镜手术结果为"金标准"，应用四格表计算得出HyCoSy及HyCoSy联合盆腔水造影评估输卵管通畅性的敏感度、特异度、阳性预测值、阴性预测值和准确性。

腹腔镜手术结果显示，72例患者的144条输卵管中88条输卵管阻塞，56条输卵管通畅。HyCoSy结果显示，87条输卵管阻塞，57条输卵管通畅。HyCoSy联合盆腔水造影结果显示，89条输卵管阻塞，55条输卵管通畅。盆腔水造影提示，89条阻塞的输卵管中伞端阻塞80条；伞端部分阻塞9条。HyCoSy诊断输卵管阻塞的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为92.0%、89.3%、93.1%、87.7%、91.0%。HyCoSy联合盆腔水造影评估输卵管阻塞的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为100.0%、98.2%、98.9%、100.0%、99.3%。2种方法的诊断准确性比较，差异有统计学意义（χ²=10.147，P<0.05）。

HyCoSy联合盆腔水造影对输卵管通畅性的评估具有良好的临床应用价值，诊断效能较好，尤其可加强对于输卵管伞端及周围盆腔内环境的评估效果，不失为一种不孕症女性病因筛查诊断的有效和可靠方法。

To evaluate the application value of hysterosalpingo-contrast sonography (HyCoSy) combined with normal saline injections into the pelvic cavity in evaluation of fallopian tube patency and fimbria.

Seventy-two patients who were diagnosed with obstruction of one or both sides of the fallopian tube or partial obstruction caused by pelvic adhesions were collected from April 2018 to February 2019 at Zhejiang Provincial People′s Hospital. HyCoSy combined with normal saline injections into the pelvic cavity were performed in all patients, and all of them underwent laparoscopy with chromopertubation within 6 months. Using laparoscopic surgery resultsas the "gold standard", the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of HyCoSy alone and HyCoSy combined with normal saline injections into the pelvic cavity for evaluating obstruction of tubal patency and fimbria were calculated by using a four-grid table.

Laparoscopy with chromopertubation showed that of the 144 fallopian tubes tested, 88 were obstructed and 56 were patent; HyCoSy alone showed that 87 fallopian tubes were obstructed and 57 were patent; HyCoSy combined with normal saline injections into the pelvic cavity showed that 89 fallopian tubes were obstructed and 55 were patent; and normal saline injections into the pelvic cavity alone showed that 80 fallopian tubes were obstructed and 9 were partly obstructed. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of HyCoSy alone in the diagnosis of obstruction of tubal patency were 92.0%, 89.3%, 93.1%, 87.7%, and 91.0%, respectively; the corresponding values of HyCoSy combined with normal saline injections into the pelvic cavity were 100.0%, 98.2%, 99.3%, 98.9%, and 100.0%. The diagnostic accuracy of HyCoSy combined with normal saline injections into the pelvic cavity was significantly higher than that of HyCoSy alone (P<0.05).

HyCoSy combined with normal saline injections into the pelvic cavity has good clinical application value and diagnostic efficiency in fallopian tube patency and fimbria, because it can strengthen the evaluation effect of the fallopian tube fimbria end and the surrounding pelvic environment. HyCoSy combined with normal saline injections into the pelvic cavity can be regarded as an effective and reliable method for etiology screening and diagnosis in infertile women.