Disorders of the fallopian tube play a very important role in both infertility and gynaecological oncology. Tubal factor infertility is considered among the leading causes of female factor infertility. Many tubal diso...Disorders of the fallopian tube play a very important role in both infertility and gynaecological oncology. Tubal factor infertility is considered among the leading causes of female factor infertility. Many tubal disorders are related to infertility including congenital anomalies, acute and chronic inflammatory diseases, endometriosis and other pathologies that result in partial or total fallopian tube obstruction. In the field of gynaecological oncology, ovarian surface epithelial tumors remain one of the most fatal malignancies in women worldwide carrying the worst prognosis among female genital malignancies. For decades, the cell of origin of epithelial tumors has remained controversial and was largely believed to be surface ovarian epithelium. Recently several studies suggested that there is a major role of the fallopian tube in the development of ovarian surface epithelial tumors, mainly high grade serous carcinoma and other tumour types. In this article we review the role of the fallopian tube in both infertility and gynaecological oncology.展开更多
Presented in this paper are results of diagnostic and therapeutic radiological intervention for 110 cases of fallopian tube obstruction. Unilateral or bilateral recanalization was achieved in 89 cases, with a success ...Presented in this paper are results of diagnostic and therapeutic radiological intervention for 110 cases of fallopian tube obstruction. Unilateral or bilateral recanalization was achieved in 89 cases, with a success rate being 80. 91%.Among the 89 patients, patency was achieved by first step treatment(regularHSG) in 40 cases (46%) and recanalization was successeful in 49 patients(54%) by sencond and/or third step (selective salpingography plus guide wire). Inthe 49 cases, 96 occluded tubes were involved, including 89 tubes with proximalobstruction (interstitia-isthmus portion) and 7 tubes with medial-distal obstruction (isthmus-ampulla portion). The success rates for proximal and medial-distalobstruction were 92. 2% and 7. 8% respectively. Follow-up results of 45 casesrevealed that the tubes of remained patent in 30 cases; 40 became pregnant, among them, 9 gave normal birth of babies; occlusion re-developed in only onecase. The authors believe that this radiological intervention can avoid false positive findings frequently occurring with use of regular HSG, thereby enhancing diagnostic accuracy. The selective salpingography could directly increase the intratubal hydrostatic pressure , remove the debris and amiliorate the inflammatoryadhersion in the fallopian tubes; selective salpingography plus guide wire recanalization can recanalize the tubes with proximal obstruction with satisfactory results. We recommend the method for the pre-treatment of 'test tube baby' procedure.展开更多
目的:系统评价宫腹腔镜术结合中医疗法对输卵管阻塞性不孕症的临床疗效。方法:计算机检索中国生物医学文献数据库、中国知网、维普数据库、万方数据库、Pub Med、Embase、Web of Science、Cochrane Library等中英文数据库及中国临床试...目的:系统评价宫腹腔镜术结合中医疗法对输卵管阻塞性不孕症的临床疗效。方法:计算机检索中国生物医学文献数据库、中国知网、维普数据库、万方数据库、Pub Med、Embase、Web of Science、Cochrane Library等中英文数据库及中国临床试验注册中心和Clinical Trials。经过文献筛选临床随机对照试验(Randomized Controlled Trial,RCT)并进行治疗评价后提取有效数据,基于Rev Man 5.3软件进行Meta分析。结果:29篇文献被纳入,共计2588例患者。Meta分析结果表明,宫腹腔镜术结合中医疗法组与宫腹腔镜术组的宫内妊娠率的比较,差异有统计学意义[相对危险度(RR)95%置信区间(CI)=1.77(1.63,1.92),P<0.001];两组输卵管通畅率比较,差异有统计学意义[RR(95%CI)=1.38(1.20,1.58),P<0.001];两组总有效率相比,差异显著[RR(95%CI)=1.25(1.18,1.33),P<0.001];两组异位妊娠率相比,亦具有显著性差异[RR(95%CI)=0.51(0.35,0.75),P<0.001]。在中医外治亚组、中医内治亚组、中医内外疗法治疗亚组,两组输卵管通畅率的比较,在统计学上均表现有显著性差异:[RR=1.62(1.16,2.27),P<0.01],[RR=1.24(1.06,1.44),P<0.01],[RR=1.59(1.13,2.23),P<0.01]。所有纳入文献中仅有1篇对患者医治过程的不良反应进行了描述。结论:与宫腹腔镜术治疗相比,宫腹腔镜术结合中医疗法可以提高输卵管阻塞性不孕症患者在治疗后的宫内妊娠率、输卵管通畅率及总有效率,降低异位妊娠率,不良反应较少,有效性和安全性较高。展开更多
目的:本研究旨在探讨子宫输卵管四维超声造影在不孕症诊断中的应用价值,并与传统输卵管造影进行比较分析。方法:选取106例不孕症患者作为研究对象,观察组接受子宫输卵管四维超声造影检查,对照组接受传统输卵管造影(X线下输卵管碘油造影...目的:本研究旨在探讨子宫输卵管四维超声造影在不孕症诊断中的应用价值,并与传统输卵管造影进行比较分析。方法:选取106例不孕症患者作为研究对象,观察组接受子宫输卵管四维超声造影检查,对照组接受传统输卵管造影(X线下输卵管碘油造影)检查,观察两组患者诊断灵敏度、特异度、PPV、NPV、输卵管通畅性的检查结果及患者满意度。结果:结果显示,子宫输卵管四维超声造影在灵敏度、特异度、PPV和NPV方面略高于传统造影,差异具有统计学意义(P<0.05);子宫输卵管四维超声造影的患者满意度高于传统造影,差异具有统计学意义(P<0.05)。四维超声造影组的样本量为53,其中通畅的有33例,通而不畅的有11例,阻塞的有9例。传统造影组的样本量也为53,其中通畅的有27例,通而不畅的有13例,阻塞的有13例。在通畅方面,四维超声造影组的通畅率高于传统造影组(33/53 vs. 27/53),且差异具有统计学意义(χ^(2)=5.281,P<0.05);在通而不畅方面,两组之间的差异没有统计学意义(χ^(2)=0.776,P>0.05);在阻塞方面,四维超声造影组的阻塞率低于传统造影组(9/53 vs. 13/53),且差异具有统计学意义(χ^(2)=3.291,P<0.05)。结论:通过对比两组数据,发现子宫输卵管四维超声造影在不孕症诊断中具有准确性、可靠性及与传统方法的比较优势。同时,该方法具有无创性、无辐射、明确的图像显示、多参数评估等优点。因此,子宫输卵管四维超声造影可以作为一种新的不孕症诊断方法,为临床医生提供可靠的诊断依据。其在不孕症治疗中有重要的意义和广阔的前景。展开更多
文摘Disorders of the fallopian tube play a very important role in both infertility and gynaecological oncology. Tubal factor infertility is considered among the leading causes of female factor infertility. Many tubal disorders are related to infertility including congenital anomalies, acute and chronic inflammatory diseases, endometriosis and other pathologies that result in partial or total fallopian tube obstruction. In the field of gynaecological oncology, ovarian surface epithelial tumors remain one of the most fatal malignancies in women worldwide carrying the worst prognosis among female genital malignancies. For decades, the cell of origin of epithelial tumors has remained controversial and was largely believed to be surface ovarian epithelium. Recently several studies suggested that there is a major role of the fallopian tube in the development of ovarian surface epithelial tumors, mainly high grade serous carcinoma and other tumour types. In this article we review the role of the fallopian tube in both infertility and gynaecological oncology.
文摘Presented in this paper are results of diagnostic and therapeutic radiological intervention for 110 cases of fallopian tube obstruction. Unilateral or bilateral recanalization was achieved in 89 cases, with a success rate being 80. 91%.Among the 89 patients, patency was achieved by first step treatment(regularHSG) in 40 cases (46%) and recanalization was successeful in 49 patients(54%) by sencond and/or third step (selective salpingography plus guide wire). Inthe 49 cases, 96 occluded tubes were involved, including 89 tubes with proximalobstruction (interstitia-isthmus portion) and 7 tubes with medial-distal obstruction (isthmus-ampulla portion). The success rates for proximal and medial-distalobstruction were 92. 2% and 7. 8% respectively. Follow-up results of 45 casesrevealed that the tubes of remained patent in 30 cases; 40 became pregnant, among them, 9 gave normal birth of babies; occlusion re-developed in only onecase. The authors believe that this radiological intervention can avoid false positive findings frequently occurring with use of regular HSG, thereby enhancing diagnostic accuracy. The selective salpingography could directly increase the intratubal hydrostatic pressure , remove the debris and amiliorate the inflammatoryadhersion in the fallopian tubes; selective salpingography plus guide wire recanalization can recanalize the tubes with proximal obstruction with satisfactory results. We recommend the method for the pre-treatment of 'test tube baby' procedure.
文摘目的:系统评价宫腹腔镜术结合中医疗法对输卵管阻塞性不孕症的临床疗效。方法:计算机检索中国生物医学文献数据库、中国知网、维普数据库、万方数据库、Pub Med、Embase、Web of Science、Cochrane Library等中英文数据库及中国临床试验注册中心和Clinical Trials。经过文献筛选临床随机对照试验(Randomized Controlled Trial,RCT)并进行治疗评价后提取有效数据,基于Rev Man 5.3软件进行Meta分析。结果:29篇文献被纳入,共计2588例患者。Meta分析结果表明,宫腹腔镜术结合中医疗法组与宫腹腔镜术组的宫内妊娠率的比较,差异有统计学意义[相对危险度(RR)95%置信区间(CI)=1.77(1.63,1.92),P<0.001];两组输卵管通畅率比较,差异有统计学意义[RR(95%CI)=1.38(1.20,1.58),P<0.001];两组总有效率相比,差异显著[RR(95%CI)=1.25(1.18,1.33),P<0.001];两组异位妊娠率相比,亦具有显著性差异[RR(95%CI)=0.51(0.35,0.75),P<0.001]。在中医外治亚组、中医内治亚组、中医内外疗法治疗亚组,两组输卵管通畅率的比较,在统计学上均表现有显著性差异:[RR=1.62(1.16,2.27),P<0.01],[RR=1.24(1.06,1.44),P<0.01],[RR=1.59(1.13,2.23),P<0.01]。所有纳入文献中仅有1篇对患者医治过程的不良反应进行了描述。结论:与宫腹腔镜术治疗相比,宫腹腔镜术结合中医疗法可以提高输卵管阻塞性不孕症患者在治疗后的宫内妊娠率、输卵管通畅率及总有效率,降低异位妊娠率,不良反应较少,有效性和安全性较高。
文摘目的:本研究旨在探讨子宫输卵管四维超声造影在不孕症诊断中的应用价值,并与传统输卵管造影进行比较分析。方法:选取106例不孕症患者作为研究对象,观察组接受子宫输卵管四维超声造影检查,对照组接受传统输卵管造影(X线下输卵管碘油造影)检查,观察两组患者诊断灵敏度、特异度、PPV、NPV、输卵管通畅性的检查结果及患者满意度。结果:结果显示,子宫输卵管四维超声造影在灵敏度、特异度、PPV和NPV方面略高于传统造影,差异具有统计学意义(P<0.05);子宫输卵管四维超声造影的患者满意度高于传统造影,差异具有统计学意义(P<0.05)。四维超声造影组的样本量为53,其中通畅的有33例,通而不畅的有11例,阻塞的有9例。传统造影组的样本量也为53,其中通畅的有27例,通而不畅的有13例,阻塞的有13例。在通畅方面,四维超声造影组的通畅率高于传统造影组(33/53 vs. 27/53),且差异具有统计学意义(χ^(2)=5.281,P<0.05);在通而不畅方面,两组之间的差异没有统计学意义(χ^(2)=0.776,P>0.05);在阻塞方面,四维超声造影组的阻塞率低于传统造影组(9/53 vs. 13/53),且差异具有统计学意义(χ^(2)=3.291,P<0.05)。结论:通过对比两组数据,发现子宫输卵管四维超声造影在不孕症诊断中具有准确性、可靠性及与传统方法的比较优势。同时,该方法具有无创性、无辐射、明确的图像显示、多参数评估等优点。因此,子宫输卵管四维超声造影可以作为一种新的不孕症诊断方法,为临床医生提供可靠的诊断依据。其在不孕症治疗中有重要的意义和广阔的前景。
