高压注射器恒速法与手工推注法在HSG中对输卵管阻塞性不孕的诊断价值

Constant rate infusion with high-pressure syringe versus manual injection of contrast medium during hysterosalpingography for diagnosis of infertility due to tube obstruction

目的：比较高压注射器恒速注射法与手工推注法在输卵管造影（HSG）中应用价值。方法：收集2009年10月一2010年4月期间广州市番禺中心医院和广州中医药大学第一附属医院各100例不孕症患者，按照不同推注方法分成试验和对照两组。试验组采用高压注射器推注对比剂，压力值设定为100PSI；对照组采用手工推注对比剂。结果：子宫畸形者，试验组、对照组分别为6例、3例，官腔粘连者两组均为9例（P〉0．05）。输卵管通畅率试验纽与对照纽分别为68．93％（122／177）、58．25％（113／194）（P〈0．05）。对比剂盆腔弥散不均匀者分别为25％（23／92），34％（34／100），P〉0．05；对比剂不同程度逆流者分别为20．65％（19／92）、11％（11／100），P〈0．05。近端阻塞率试验组10．73％，对照组18．56％（P〈0．05）。结论：高压注射器应用于HSG中，在提高输卵管通畅率、降低近端阻塞率具有一定的诊断及治疗意义，优于传统手工推注方法，适合于临床普遍推广。

Objective：To compare the value of constant rate infusion with high-pressure syringe and manual injection of contrast medium during hysterosalpingography for diagnosis of infertility due ＂to tube obstruction. Methods： Each of 100 patients with infertility, registered to Guangzhou Panyu Central Hospital and First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine between October 2009 and April 2010, were enrolled and allocated to the experimental group and control group according to the injection method. Patients in experimental group underwent constant rate infusion with high-pressure syringe （pressure set at IOOPSI）, while those in control group received manual injection, of contrast medium. Results： Uterine malformation was noted in 6 patients from the experimental group and 3 from the control group, as was intrauterine adhesions in 9 cases from each group. Tubal patency was found in 68.93% of cases from the experimental group vs 58.25% from the control group（P 〈0. 05）. 25% （23/92） vs 34% （34/100） of the cases in the experimental group and control group （P 〉 0.05 ）, respectively, showed uneven pelvic diffusion of contrastmedium,20.65% （19/92） vs 11% （11/100） showed some degree of contrast reflux（P 〈0. 05）, and 10.73% vs 18.56 showed proximal tube obstruction （ P 〈 0.05 ）. Conclusion ： The use of high-pressure syringe in HSG may be a diagnostic and therapeutic approach superior to manual injection in improving tubal patency and reducing proximal obstruction, and therefore suitable for widespread use.