B超监护下宫腔镜下输卵管插管检查输卵管通畅性

Using hysteroscopy combined with ultrasonography monitoring to check the unobstruction of oviductsO

目的:探讨术前服用米索前列醇扩张宫颈,在宫腔镜下行输卵管口插管注液疏通术的临床效果。方法:280例不孕患者术前3 h口服米索前列醇扩张宫颈,用WOLF外鞘21Fr的宫腔治疗镜进行注液疏通术,联合B超监测检查输卵管通畅性。结果:280例患者中双侧输卵管完全通畅65例,占23.21%;一侧通畅另一侧通而不畅80例,占28.57%;双侧通而不畅56例,占22.14%;一侧通畅而另一侧不通35例,占12.50%;双侧不通44例,占15.71%;发现宫腔异常35例,占12.51%。对44例双侧不通的患者行宫腹腔镜联合检查,除6位因患宫外孕切除6条患侧输卵管外,44例患者中共有82条输卵管,其中输卵管远端不通48条,近端不通34条。B超监护下宫腔镜下输卵管插管与宫腹腔镜联合两种检查方法相比较,P>0.01,无统计学意义。结论:B超监护下宫腔镜下输卵管插管注液疏通术检查输卵管通畅性是一种诊断准确性高、安全、可同时达到诊断与治疗目的的方法。

Objective： To evaluate the clinical value of using hysteroscopy combined with ultrasonography monitoring in checking the unobstruction of oviduct. The patients who under hysteroscopy, pluging and injecting the oviducts to let them clear, need to take misoprostol to expand cervix uteri before operation. Methods： 280 infertile patients who take misoprotal to expand cervix uteri three hours before operation received hysteroscopy and pluging and injecting the oviducts. The hysteroscope was equipped with WOLF outer covering 21Fr. Resuits： In the 280 infertile patients, 65cases were founds both two side oviducts totally clear （23. 21% ） , go cases were found one side oviduct totally clear and another side open but not clear （28. 57） , 56 cases were found both two side oviducts open but not clear （22. 14% ） , 35cases were found one side oviduct clear and another side open but not clear （ 12. 50） , 44 cases were found both two side oviducts not clear （ 15. 71 ）, And 35 cases were found uterine carity abnormal （ 12, 51 ）. In the 44 patients , 6 were resected the suffering 6 oviducts because of extrauterine pregnancy. So in the remain 82 oviducts, 48 were found the far - extremity not clear while 34 were found the near extremity not clear. If the 44 patients received hysteroscopy combined with laparocopy, the results were the same. The two methods were not significantly different （P 〉0.01 ）. Conclusion： Using hysteroscopy combined with ultrasonography monitoring to check the unobstruction of oviduct was a good method. It is workable, with high accuracy of diagnoses, safe and it also can get both diagnose and cure at the same time.