子宫腔碘水加压法输卵管再通术的临床研究

目的寻求一种简便快速、安全有效、经济实用,将造影诊断与输卵管再通治疗结合起来的新方法。方法应用双腔球囊胶管插入子宫腔,充盈球囊堵塞子宫颈内口,用助推器注入碘海醇充盈子宫腔及输卵管,电视动态观察实时点片,完成造影诊断。当发现输卵管阻塞时,用手助推加压,逐渐增高宫腔内压力,使阻塞输卵管被造影剂压力钝性开通。结果本组2698例,插管成功2685例。其中,原发不孕806例,继发不孕1868例,其他24例,输卵管阻塞3082支(右1561支、左1521支),占实有输卵管的59%,加压开通率为77.8%(2397/3082);通而不畅343支(右175支、左168支),加压开通率:93.9%(322/343),出现静脉逆流27例。除局部疼痛及少量阴道流血外,无严重并发症病及病死率。结论该法简便快速,安全有效,经济实用,将造影诊断与输卵管再通相结合,深受患者欢迎,值得推广应用。

A clinical study of fallopian tube recanalization by comptesswely injecting contrast medunm into the uterus

Objective To search for a new, simple, rapid, safe and effective method with combination of hystero. salingography and fallopian tube recanalization. Methods After the double-lumen balloon cather was inserted into the uterine cavity and then followed by saline or air injection into to the saccule .The internal os of cervix was thus blocked by the filled saccule. Iohexol was injected into uterine cavity and fallopian tubes to undertake hystero-salingography and selective radiography under the television observation. In cases of obstruction the fallopian tube recanalization could be obtained by manual increasing the contrast injection pressure into the uterine cavity. Results 2698 cases including 811 primary infertile women and 1887 cases of secondary infertilities were examed by this method. The number of obstructed fallopian tube was 3082 including 1561 right fallopian tubes and 1521 left ones. The rate of tube obstruction was 77.77% and that of tube recanalization was 88.96% incuding 2397 branches recanalized completely and 322 partially recanalizd. The venous reflux was found in 27 cases and light complications included slight vagina bleeding, mild transient spastic pain without mortality. Conclusion This method of combining hystero- salingography and fallopian tube recanalization, is safe, effective, economic and practical for infertile women with quick procedure process;and worthy to be recommonded. (J Intervent Radiol, 2006, 15: 286-289)