Fertil Steril. 1986 Dec;46(6):1101-7.
A World Health Organization-sponsored multicentered trial comparing the efficacy of gaseous tubal insufflation with hysterosalpingography (HSG) and/or laparoscopy plus dye hydrotubation in the assessment of tubal patency was undertaken. Three hundred ninety-three women in eight centers were involved (365 insufflations, 289 HSG, 189 laparoscopy). Patency was proven positive in 56% of insufflation, 45% of salpingography, and 52% of laparoscopy cases. Laparoscopy showed some women to have fibroids and a number of others to have ovarian abnormalities, endometriosis, pelvic adhesions, and/or congenital uterine malformation. Comparison of insufflation and HSG showed a false-positive rate of 42% and false-negative rate 24% in 363 cases. The false-positive rate of insufflation versus laparoscopy was 35% and the false-negative rate 38% of 180 cases. Only 55% of 125 women undergoing both HSG and laparoscopy had similar findings. The results suggest that gaseous tubal insufflation should not be employed as a method of investigating tubal patency. Diagnostic reliability of HSG is poor, but it is useful as a primary screening procedure, particularly when complimented with laparoscopy plus dye hydrotubation, which is the optimum method not only for assessing tubal patency but for discovering other hitherto unsuspected disease.
开展了一项由世界卫生组织赞助的多中心试验，比较气体输卵管通气术与子宫输卵管造影术（HSG）和/或腹腔镜检查加输卵管通液术在评估输卵管通畅性方面的疗效。八个中心的393名女性参与其中（365例通气术、289例子宫输卵管造影术、189例腹腔镜检查）。通气术病例中56%、输卵管造影术病例中45%、腹腔镜检查病例中52%的通畅性被证实为阳性。腹腔镜检查显示一些女性患有子宫肌瘤，其他一些女性患有卵巢异常、子宫内膜异位症、盆腔粘连和/或先天性子宫畸形。通气术与子宫输卵管造影术的比较显示，363例病例中的假阳性率为42%，假阴性率为24%。通气术与腹腔镜检查相比，180例病例中的假阳性率为35%，假阴性率为38%。在接受子宫输卵管造影术和腹腔镜检查的125名女性中，只有55%的检查结果相似。结果表明，气体输卵管通气术不应作为调查输卵管通畅性的方法。子宫输卵管造影术的诊断可靠性较差，但作为一种初步筛查程序很有用，特别是当与腹腔镜检查加输卵管通液术相结合时，后者不仅是评估输卵管通畅性的最佳方法，也是发现其他此前未被怀疑疾病的最佳方法。
