X光监导下行宫腔镜输卵管插管造影和疏通术

Study on the New Treatment of Infertile Women with Tubal Obstruction by Hysteroscopy Tubal Catheterization and Hydrotubation under the Monitor of X-ray

目的:观察X光监导宫腔镜下输卵管插管造影和疏通诊治输卵管近端梗阻的疗效。方法:选择经子宫输卵管造影诊断为单侧或双侧输卵管间质部梗阻的不孕患者43例,共79条输卵管,经宫腔镜将输卵管间质部导管插入输卵管间质部约0.5～0.8mm,注入美蓝,如有外漏,采用抽蕊导管,再注入美兰确认无误后,注入药液,阻力变小后将76％泛影葡胺注入输卵管,在X线荧光屏下观察输卵管造影情况,并摄盆腔X线片,与治疗前比较。结果:疏通治疗一次完全通畅占62％,有改善占30.4％,无效占7.6％。在输卵管完全通畅的28例中,随访超过半年以上者,12例已获宫内妊娠,无异位妊娠发生。结论:此方法是诊治 部分输卵管间质部梗阻的一种安全、简便的方法。

Objective: To assess the new treatment of infertile women with tubal obstruction by hysteroscopy tubal catheteriza-tion and hydrotubation under the monitor of X - ray. Methods; 43 infertile women with one or two interstitial portion tubal obstruction diagnosed by hysterosalpingography (HSG) undergo hysteroscopic tubal catheterization and hydrotubation. Mei Lan was injected into 79 tubals of the infertile women through an interstitial portion tube which was inserted into the interstitial portion about 0. 5 - 0. 8mm deep with the help of hysteroscope. If Mei Lan spilt out, it should be transported into interstitial portion through inner catheter again till there is no spill. With the decrease of the resistance, 76% Meglumine diatrizoate was injected into the tubals, while the X - ray film of the lumen was being taken under HSG and compared with the X - ray film taken before treatment. Results; 62% of the patients'tubals became unobstructed in only once surgery, 30.4% of the patients 'condition was improved after the treatment, and no effect takes place in the rest 7.6%. In the exceeding - six - month follow - up observations, 12 women out of 28 whose tubals have become completely unobstructed achieved intrauterine pregnancies and no dislocation of pregnancy occured. Conclusion; This kind of treatment is a safe and effective one for diagnosing and dealing with interstitial tubal obstruction.