选择性输卵管造影与再通术对输卵管近端梗阻的疗效分析

Evaluation of selective salpingography and fallopian tube recanalization for proximal tubal obstruction

目的 探讨选择性输卵管造影与再通术在诊治输卵管近端梗阻方面的安全性和有效性。方法 １０３ 例输卵管近端梗阻患者，用自制的导管施行选择性输卵管造影，若输卵管近端仍梗阻，则行输卵管再通术。结果 １３５ 条输卵管中有５１ 条仅施行选择性输卵管造影即获得再通，剩下８４ 条输卵管施行输卵管再通术后６４ 条获再通，有效率达８５ ．２ ％ 。随访３０ 例，输卵管再通术后有８ 例宫内妊娠和１例宫外孕，选择性输卵管造影术后有５ 例宫内妊娠。结论 输卵管近端梗阻，应考虑施行选择性输卵管造影或输卵管再通术，两种方法对诊治输卵管近端梗阻是安全而有效的。

Objective To evaluate the safety and efficacy of selective salpingography combined with fallopian tube recanalization for the diagnosis and treatment of proximal tubal obstruction. Methods 103 cases were diagnosed by hysterosalpingogram (HSG), selective salpingography was performed with self made catheter. If proximal tubal obstruction was still present, then followed fallopian tube recanalization. Results 51 of 135 tubes became patent by only selective salpingography, 64 of the remaining 84 tubes were made patent by fallopian tube recanalization. Effective rate was 85.2%. 30 cases of follow up showed 8 intrauterine pregnancies (IUPs) and 1 ectopic pregnancy after recanalization and 5 IUPs after selective salpingography. Conclusions Selective salpingography or fallopian tube recanalization should be considered at the time of HSG showing proximal tubal obstruction. They are a safe and effective procedure for the diagnosis and treatment of proximal tubal obstruction.