隔室推药子宫输卵管造影的临床应用

The clinical application of hysterosalpingography with compartmental administration of contrast agent

目的探讨隔室手推造影剂子宫输卵管造影的应用价值。方法将12F硅胶球囊导管插入子宫腔,注入2～3mL生理盐水充盈球囊,使球囊堵塞子宫颈内口。延长管与球囊导管和注射器相接,用适当的压力推注造影剂,在电视监视下,确定导管位置良好且嵌塞后,逐渐加压,在子宫腔输卵管逐步充盈时,实时摄片。遇输卵管阻塞时,加压推注,能使轻度粘连阻塞的输卵管再通,发现逆流立即停止推药。结果本组检查2300例,一次造影成功2116例(92%);二次造影成功115例(5%);改用子宫颈塞法手推造影69例(3%)。造影示子宫输卵管正常483例(21%),子宫病变207例(9%),输卵管病变1610例(70%),其中,463例(28.7%)阻塞的输卵管再通。患者无须在放射科插管,医师、患者受照辐射量少,推注压力能灵活调节,未出现严重的并发症。结论该法简便、经济实用、安全、推注压力可调节,图像清晰、隔室推药,辐射剂量小,对轻度粘连阻塞的输卵管有再通作用,值得推广应用。

Objective To investigate the value of hysterosalpingography（HSG） with compartmental hand-pushing administration of contrast agent. Methods The 12 F silicagel sacculus catheter was inserted into the cavity of uterus. The astium uteri internum was walled up by sacculus which was filled with 2-3 mL physiological saline. Then the extension pipe was connected with sacculus catheter and in- jector. The injector was pushed with appropriate pressure to make sure that the catheter was impacted, and then took radiography at real time while the uterus and oviduct were filled under suitable pressure. Pushing the injector with compression could recanalized the gentle conglutination of oviduct, while stopped pushing immediately if the anarrhea occurred. Results HSG was carried out in 2 300 cases, of which the HSG succeed first time in 2 116（92%）, second time in 115（5%）, changed to HSGwith uterus neck plug in 69（3%）. As a result, HSG showed normal in 483 （21%）, pathological uterus in 207 （9%）, pathological oviduct in 1 610 （70%）. There were 463 cases whose oviduct obstruction were recanalized. There was no need to inserting catheter in radiological department. The doctor and the patients suf- fered little radiation dose. Also ,pushing pressure could be eligible regulated. There were no severe complications related to the procedure. Conclusions HSG with compartmental hand-pushing administration of contrast agent has characteristic of practicality, safety and little radiation and therefore it is deserved an expansion application.