输卵管通而不畅的诊治方法

Diagnosis and treatment of incomplete occlusion of fallopian tube

在输卵管性不孕症的诊疗中,输卵管通而不畅占有相当的比率,诊断准确、治疗及时,其自然受孕率较高。虽然有人认为妇科内镜(腹腔镜联合宫腔镜)可以作为诊断和评价输卵管性不孕的金标准,并成为治疗的主要手段之一,但由于其费用高、创伤性相对较大,而且受术者操作技术影响较大,使其应用受到了一定的限制。子宫输卵管造影术广泛用于临床,它作为初步筛查的首选方法得到普遍认可。选择性输卵管造影和输卵管再通术在诊断及治疗输卵管通而不畅方面明显优于子宫输卵管造影术,在一定程度上可与腹腔镜相媲美,而且可动态观察输卵管功能,不良反应较少,安全性高、费用低,临床应用越来越广泛。

Incomplete occlusion of fallopian tube is a common cause for fallopian tubal intertility. However, the spontaneous intrauterine pregnancy rate may be increased after the patients receive appropriate diagnosis and treatment. Laparoscopy combined with hysteroscopy has been regarded to be a golden standard for diagnosis and treatment of fallopian tubal infertility, but its clinical application has been markedly limited due to its invasiveness and great expense. As the first-line screening technique, hysterosalpingography has been widely used to evaluate the fallopian tube patency. Selective salpingography and fallopian tube recanalization are more superior to hysterosalpingography in diagnosing and treating incomplete occlusion of fallopian tube. Selective salpingography and fallopian tube recanalization can even be on a par with laparoscopy, and moreover, can dynamically observe the fallopian tube function as well. As a safe and economical technique with fewer side-effects, selective salpingography plus fallopian tube recanalization has been more widely employed in clinical practice.