宫腔镜输卵管注药治疗输卵管梗阻性不孕症(附54例临床分析)

Hysteroscopic Tubal Catheterization and Hydrotubation for Treatment of Infertile Women with Tubal Obstruction

本文报道54例(含102条输卵管)输卵管梗阻性不孕妇女,经宫腔镜输卵管插管注药术治疗三次,治疗前、后均作子宫输卵管碘油造影比较。治疗后86条输卵管通畅度改善(84%),与治疗前有非常显著性差异(P<0.01),其中56条输卵管通畅(54.9%),30条好转(29%)和16条无效(16%),按输卵管条数计,此术用于输卵管通而欠畅者疗效最佳(85.7%),宫角梗阻疗效较好(62.5%),而伞部梗阻疗效最差(13.3%)。治疗后输卵管通畅的35例中,随访1～12月已有12例获宫内妊娠。

This paper reports on the efficacy of interval hysteroscopic tubal catheterization and hydrotubation (monthly, 3 times) by comparison of HSGs before and after treatment in 54 infertile women with tubal obstruction (containing 102 fallopian tubes). Tubal patency improved in 86 out of 102 tubes (84%) after treatments (P<0.01), including 56 tubes completely patent (54.9%). Sixteen obstructive tubes remained unchanged (16%). According to the number of fallopian tubes, this therapeutic method is the most effective for partially tubal patency (effective rate: 85.7%), more effective for intramural tubal obstruction (62.5%) and less effective for distal tubal obstruction (13.3%). 1～12 months follow-up after treatments, shows that in 12 out of 35 women whose tubes have become patent completely the intrauterine pregnancies occurred.