内生殖器结核子宫输卵管碘油造影119例分析

我院自1974年10月至1982年10月在生殖器结核诊断中,施行子宫输卵管碘油造影术140例,其中诊断内生殖器结核119例,现就诊断中的体会总结如下。临床资料本组病例选择及造影方法按杨珂等要求,内生殖器结核的诊断标准按刘伯宁等的分类。本组年龄28～39岁;病史3～5年不孕者43例,5～10年不孕者51例,10年以上不孕者25例。其临床情况及X 线造影表现见附表。其中X 线碘油造影中,较可靠征象81例,可能征象38例。附表119例临床情况及造影表现     

子宫输卵管造影的图像解读

女性不孕症25%～35%由输卵管不孕症引起，子宫输卵管造影是诊断输卵管不孕症的一线方法。文章探讨输卵管通而不畅，输卵管近端阻塞，结节性输卵管峡部炎，输卵管远端积水，盆腔粘连，盆腔结核等常见输卵管病变的造影图像表现，以指导临床诊断和手术预后评估。     

子宫输卵管超声造影的研究进展

婚后妇女约有１５％患有不孕症，其中２５％～３０％系输卵管因素造成。因而，输卵管功能的评价对不孕症的治疗具有重要的意义。目前，判定输卵管通畅度的方法有输卵管通气或通液术、子宫输卵管碘油造影术（ＨＳＧ）、腹腔镜或宫腔镜输卵管通液术、ＣＴ、ＭＲＩ等。近年来，子宫输卵管超声造影检查逐渐进入临床，并受到学者们的青睐。现就这方面的研究进展作一综述。     

子宫镜下选择性输卵管造影

经子宫输卵管造影法诊断为输卵管阻塞的病例,不少经腹腔镜检查却是通畅的,尤其输卵管近子宫端阻塞多半不是器质性的,而选择性输卵管造影除能疏通输卵管,还能提高压力。 选择性输卵管疏通法有选择性输卵管造影法和经阴道输卵管疏通术。前者在X线透视下或子宫镜下分别在左右选择性注入造影剂;后者向输卵管插     

子宫输卵管双氧水声学造影的研究

<正> 输卵管通畅试验是不孕症检查的基本方法之一。80年代以来,国内外开始探索应用实时B 超显像技术检查输卵管通畅情况。我们于1989年7月至1990年4月对62例女性不孕患者进行了双氧水子宫输卵管声学造影     

500例输卵管性不孕症子宫输卵管造影的评价

诊断子宫性和输卵管性不孕症常用染色腹腔镜检和子宫输卵管造影术(HSG).子宫输卵管造影是比较无害价廉的检查方法,可以明确宫腔情况和输卵管阻塞的部位.1973～1980年Rostock Wilhem-Piect大学的Bereichs医学院妇科医院对不孕症的诊断首先应用HSG,目的是对输卵管性不孕症、妊娠进行HSG和拍片质量的评价.排除一般疾病和生殖道炎症,于排卵前应用双球形导管     

子宫输卵管造影对输卵管性不孕的诊断价值

子宫输卵管造影用以评价输卵管的通畅度,是不孕症的一线诊断方法.但因其诊断符合率不高以及存在一定的并发症,影响了临床应用.传统的碘油造影虽然造影图像效果好,但并发症较多,甚至可有碘油肺栓塞等严重并发症.水溶性造影剂使用安全,省时方便且显影效果满意,有取代碘油的趋势,为提高造影诊断符合率,应改进造影技术以获取满意图像,加强对盆腔结核及盆腔粘连等非典型造影图像的认识,同时也应加强医师培训以提高造影诊断的一致性.     

子宫输卵管碘油造影与超声双氧水造影对输卵管检查的比较

输卵管因素所致的不孕占女性不孕的 2 5 %～ 4 0 % [1] 。正确判断输卵管的形态及功能是治疗女性不孕症的关键之一。目前检查输卵管的方法有多种 ,而在基层医院能够开展的主要是子宫输卵管超声双氧水造影术 (以下简称声学造影 )及子宫输卵管碘油造影术 (以下简称碘油造影 )。笔者收集到 119例行碘油造影前曾进行过声学造影的不孕症患者的资料 ,分析如下。资料与方法一、临床资料1997年 6月～ 2 0 0 2年 6月 ,在我院行碘油造影前曾经进行过声学造影的不孕症患者 119例 ,年龄 2 2～ 4 1岁 ,平均 2 4 6岁。原发不孕 4 1例 ,占 34 4 5 % ,平均…     

子宫输卵管双重造影50例体会

我院对50例患者使用水溶性复方泛影葡胺和空气进行子宫输卵管双重造影(也称双对比造影),获得满意效果,现介绍如下。资料与方法1.方法:术前做碘过敏试验,肌注654—2液20mg。排空大小便,外阴、阴道、宫颈消毒后,由宫口插入双腔子宫造影导管,将气囊充气固定,以30%复方泛影葡胺注射液缓慢注入宫腔5～10ml,在X 线电视下观察子宫输卵管充盈情况,随时摄片。当充盈良好或有造影剂进入腹腔时,停止注药,并由导管排出部分造影剂,在X 线电视监视下注入5～10ml 滤过的空     

Hysterosalpingographic findings in infertile women with genital tuberculosis

OBJECTIVES: To evaluate the hysterosalpingographic findings from infertile women who were subsequently diagnosed with genital tuberculosis. METHODS: A retrospective study of 70 infertile women who underwent hysterosalpingography to investigate infertility and were subsequently diagnosed with genital tuberculosis. RESULTS: The mean age of the women was 27.3 years and the mean duration of infertility was 6.1 years. A total of 57 (81.4%) women had primary infertility while 13 had secondary infertility. Diagnosis of genital tuberculosis was made by polymerase chain reaction (54.3%), tuberculous granuloma on biopsy (22.8%), acid-fast bacilli culture (2.8%), and at laparoscopy or hysteroscopy (20%). Hysterosalpingographic findings were a normal uterine cavity observed in 57.1% of women, an irregular cavity in 18.5%, a shrunken cavity in 2.8%, and an irregular filling defect in 18.5%. Synechiae were observed in 17.1% of women. CONCLUSION: Genital tuberculosis is a common cause of infertility in India, causing significant uterine and tubal pathologies.     

A case of tubal endometriosis mimicking the appearances of tubal pregnancy at laparoscopy

Tubal pregnancy is a common gynaecological emergency. Due to the accuracy of transvaginal ultrasonography and serum human chorionic gonadotrophin (hCG) analysis is being managed more frequently by laparoscopy in asymptomatic patients. A case of presumed tubal pregnancy is presented in which the evidence generated by ultrasonography, hCG levels and laparoscopy all suggested tubal pregnancy. However, histological examination showed a tubal endometrioma. This case highlights the importance of histological analysis of all surgical specimens and provides a rare differential diagnosis of tubal mass.     

Hysterosalpingographic follow-up of laparoscopic sterilization.

Two hundred and fifty of 323 laparoscopically sterilized patients had hysterosalpingographic (HSG) follow-up. A Foley catheter was used in hysterosalpingography. Of these patients, 3.6 per cent demonstrated fistula; 1.2 per cent were found to have round ligament burns, and 0.618 per cent became pregnant. Mechanism of fistula formation, prevention, and management is discussed. The incidence of intrauterine pregnancy and ectopic pregnancy after laparoscopic sterilization is discussed, and the literature is reviewed. Based on these data, it is concluded that HSG follow-up is helpful in teaching institutions and where the laparoscopic sterilization is carried out by inexperienced operators. Routine HSG follow-up is not recommended.     

In vitro fertilization outcome in women with endometrial tuberculosis and tubal tuberculosis

Abstract

Purpose: To evaluate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) outcome in women with genital tuberculosis (GTB).

Methods: One hundred and fifty-five women with genital tuberculosis constituted the study group (Group A), consisting of 25 patients with endometrial tuberculosis (Group A1) and 130 patients with tubal tuberculosis (Group A2). Women with non-tuberculous tubal infertility were matched by age and study period served as controls (Group B).

Results: Patients with GTB had significantly reduced endometrial thickness, high-quality embryos rate, implantation rate as compared with controls (p?<?.05), no differences were found in other pregnancy parameters. In addition, the endometrial thickness, fertilization rate, high-quality embryos rate and implantation rate were also significantly lower in women with endometrial tuberculosis as compared with controls. And the cumulative pregnancy rate in endometrial tuberculosis was significantly decreased compared with tubal tuberculosis and controls (p?<?.05). However, IVF/ICSI pregnancy outcomes in patients with tubal tuberculosis showed no difference as compared with controls (p?>?.05). Also, rates of miscarriage, preterm birth, obstetrical complications, and neonatal problems did not differ among three groups.

Conclusions: In conclusion, IVF/ICSI-ET remains the most optimal method for the treatment of female infertility associated with tubal tuberculosis. However, patients with endometrium tuberculosis showed significantly reduced fertilization, implantation and cumulative pregnancy rates.