摘要
目的探讨通液诊疗仪碘水加压法子宫输卵管造影(HSG)的临床价值。方法对103例不孕患者行HSG检查,对比剂为48%碘海醇,采用通液诊疗仪,逐渐增加子宫腔内压力,对阻塞输卵管行压力钝性疏通,疏通后行输卵管通液术。结果子宫输卵管正常17例,子宫异常6例,80例共151条输卵管阻塞,128条获管腔再通,再通率达84.8%,其中左侧输卵管开通的平均压力为24 kPa,对比剂进入盆腔的平均压力为25.3 kPa;右侧输卵管开通的平均压力为28.4 kPa,对比剂进入盆腔的平均压力为28.6 kPa;压力达50 kPa以上仍未开通的23条。开通后手推通液阻力明显下降45例、轻度下降30例、不下降5例。术中出现静脉逆流3例,局部疼痛56例,少量阴道流血50例,无盆腔感染或输卵管穿孔发生。结论通液诊疗仪碘水加压法HSG能清楚显示子宫及输卵管通畅情况,对阻塞输卵管能有效地进行压力疏通,同时具有压力量化、简单易行、安全可控等特点,值得推广应用。
Objective To assess the clinical value of pressure injection of contrast agent under the control of hydraulic pressure diagnostic and therapeutic instrument in performing hysterosalpingography for patients with infertility due to fallopian tube obstruction. Methods Under the control of hydraulic pressure diagnostic and therapeutic instrument, a total of 103 patients with infertility due to fallopian tube obstruction underwent hysterosalpingography. Pressure injection of contrast agent was adopted with an attempt to dredge the fallopian tube, which was followed by tubal patent test with liquid instillation. The results were analyzed. Results Of the 103 patients, normal hysterosalpingographic finding was seen in 17, abnormal uterus in 6 and obstruction of fallopian tube in 80. A total of 151 obstructed fallopian tubes were detected in 80 patients, of which 128 fallopian tubes were re-canalized （84.8%）. The mean pressure for re-opening the left fallopian tube was 24 kPa, and the mean pressure for pushing the contrast agent into the pelvic cavity was 25.3 kPa. The mean pressure for re-opening the right fallopian tube was 28.4 kPa, and the mean pressure for pushing the contrast agent into the pelvic cavity was 28.6 kPa. Failure to re-open the fallopian tube was seen in 23 tubes, even though the used pressure was over 50 kPa. After re- opening of the fallopian tube, the hand- pushing flow resistance was markedly decreased in 45 patients, mildly decreased in 30 patients and not decreased in 5 patients. During the procedure, venous countercurrent was seen in 3 cases, local pain in 56 cases and small amount of vaginal bleeding in 50 cases. Neither pelvic infection nor tubal perforation occurred. Conclusion Under the control of hydraulic pressure diagnostic and therapeutic instrument, hysterosalpingography with pressure injection of contrast agent can clearly display the intraeavitary conditionof the fallopian tube and the uterus, and effective recanalization of the obstructed fallopian tube with pressure can be performed with confidence. Besides, this technique has some certain advantages. The pressure used inthe procedure can be quantified, the manipulation is easy and simple, and the operation is safe and controllable. Therefore, this technique should be recommended in clinical practice.（J Intervent Radiol, 2013, 22： 071-074）
出处
《介入放射学杂志》
CSCD
北大核心
2013年第1期71-74,共4页
Journal of Interventional Radiology
关键词
不孕症
子宫输卵管造影
输卵管再通
通液诊疗仪
infertility
hysterosalpingography
fallopian tube recanalization
hydraulic pressure diagnostic and therapeutic instrument
