经输卵管注药介入治疗慢性盆腔炎性疼痛及阻塞性不孕的路径探讨和疗效观察

Path and therapeutic effects of the interventional treatment by tubal injection for chronic pelvic pain such as pelvic inflammatory disease and obstructive infertility

目的为探索治疗慢性盆腔痛及不孕的理想方法,本文尝试通过输卵管注药介入治疗盆腔炎性后遗症等疼痛疾病及输卵管阻塞性不孕,观察其疗效并对输卵管这条自身路径进一步拓宽利用进行实践论证。方法应用NCI-I型数字化输卵管通液诊断治疗仪对56例盆腔炎性等疼痛、伴有不孕或计划妊娠的患者结合超声监测通液诊断,根据输卵管通畅程度分别给予盆腔注药或输卵管疏通后介入治疗。结果 56例盆腔疼痛患者仅有19例输卵管通畅,37例输卵管阻塞(不全阻塞25例,11例不通),占66.1%。治疗后通畅组盆腔疼痛消失16例,治愈率为84.2%;不全阻塞组疼痛减轻20例,好转率为76.9%,其中14例患者输卵管得以疏通;不通组45.5%(5/11)病情好转,输卵管疏通率为63.6%(7/11);通畅组疼痛治愈率明显高于不全阻塞和不通组(P<0.05)。盆腔炎性疼痛治愈率和输卵管疏通率分别为45.5%和82.4%,内异症等疼痛组为13.0%和65.0%,后者虽不及前者理想(P<0.05),但确有60.9%患者疼痛好转。本文输卵管阻塞疏通率为72.9%,慢性盆腔疼痛治疗有效率达87.5%。结论输卵管是一条与生俱来的自身生理通道,可拓宽利用诊治盆腔疾病。NCI-I型数字化输卵管通液诊断治疗仪盆腔注药介入治疗是一种准确易行、安全无创、科学有效的诊治盆腔炎性等疾病的方法。实践证明,疏通这条路径不仅在阻塞性输卵管不孕方面起到了至关重要的临床作用,对治疗盆腔炎性后遗症等慢性盆腔疼痛疾病也有较高的研究价值,值得进一步探索和应用,并有广阔的前景和发展空间。

Objective To explore the treatment of chronic pelvic pain and tubal obstruction infertility by tubal injection so as to find an ideal way for the treatment of the diseases. Method NCI-I-type digital instrument was used, combined with ultrasonic monitoring, to diagnose 56 cases of pelvic inflammatory disease, such as pain, associated with infertility or planned pregnancy; Pe!vic cavity injection or interventional therapy after fallopian tube dredge were given according to the tubal patency, and the efficacy was analyzed. Result Of the 56 eases with pelvic pain, there were only 19 eases of smooth tubes, while 37 cases were tubal occlusion （ including 25 cases of incomplete occlusion and 11 cases of unreasonable occlusion）, accounting for 66.1%. After treatment, there were 16 eases in the Smooth group whose pelvic pain disappeared, the cure rate being 84.2% ; 20 cases in the Incomplete occlusion group experienced alleviated pain,, the improve- ment rate being 76.9%, of which 14 patients got their tubes cleared; In the Occlusion group, 45.5% （5/11） got better, with the pateney rate being 63.6% （7/11）. The cure rate of the pelvic pain of the Smooth group was significantly higher than that of the incomplete and unreasonable occlusion groups （ P 〈 0.05 ）. The cure rate of pelvic inflammatory disease related pain and the patency rate were 45.5% and 82.4% respectively, while the cure rate of endometriosis-associated painand the patency rate were 13.0% and 65.0% respectively. The overall patency rate of this study was 72.9%, and the effective rate for chronic pelvic pain was 87.5%. Conclusion Fallopian tube is a physical channel which can be used for diagnosis and treatment of pelvic diseases. NCI-I digital tubal instrument is accurate, easy-to-use, safe, noninvasive, and effective for diagnosis and treatment of pelvic inflammatory diseases. Dredging offallopian tube can contribute not only to the treatment of infertility caused by tubal obstruetion, but also to the treatment of pelvie inflammatory diseases such as chronic pelvie pain.