超声监视下输卵管通液术诊治输卵管性不孕症的临床研究
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摘要
目的:探讨超声监视下输卵管通液术对输卵管性不孕症诊断和治疗的临床价值。方法:选择例不孕妇女将通管液注入宫腔内,在B超监视下行输卵管通液术。观察输卵管腔的内径,形态及气液体通过输卵管的速度,宫腔液暗区分离宽度、附件区宫后区液体多少,术中液体注入时的阻力及患者的感觉等因素。
结果:输卵管通畅情况为:一侧通而不畅一侧通畅35例,一侧通畅一侧梗阻24例,双侧通畅97例,双侧不通畅28例,一侧不通、一侧通而不畅36例,双侧通而不畅64例,疏通术后随访4年怀孕87例。
结论:对不孕妇女行超声监视下输卵管通液术,可达到诊断治疗双重目的,诊断输卵管通畅性较准确,而且该检测方法具有操作简便、安全可靠、损伤性小、费用低廉、可重复性强、实用等优点,因此可作为不孕门诊病人的首选检查方法和初步筛选性诊治手段,在不孕症的鉴别诊断和病因诊断方面亦具有很大的临床价值,非常值得各级医院推广应用。
Objective To sdudy the clinical evaluation of diagnosing the passability by utilizing sonosalpingography of physiological saline and transvaginal ultrasonography infertile women.Methods The liquid complex was injected into the uterine cavity of the 284 infertile women. Hydrotubation were performed under the quid of B-mode ultrasongraphy. The following contents were observed: The ovduct internal diameter, shape, flowing speed of gas and liquid, seperated width of darkened liquid shadow of uterine cavity. Amount of liquid around the dnexa and uterus, injecting resistance and pationts'feeling ect. Results 284 pationts were observed: 35 cases with one side partially passable and the other side smoothly passable, 24 cases with one side passable and the other side impassable, 97 cases with both sides passable, 28cases with both sides impassable, 36 cases with one side impassable and the other side partially passable , 64 cases with both sides partially passable, 87 cases were pregnant 4 year after the operation. Conclusions Under the guid of the B-mode ultrasonographyhydrotubation is useful in diagnosis and treatment in infertile women. This method takes the advantages of accuracy, security, easy operation and practical . It should be the first choice in tube passable test of Infertility.
结果:输卵管通畅情况为:一侧通而不畅一侧通畅35例,一侧通畅一侧梗阻24例,双侧通畅97例,双侧不通畅28例,一侧不通、一侧通而不畅36例,双侧通而不畅64例,疏通术后随访4年怀孕87例。
结论:对不孕妇女行超声监视下输卵管通液术,可达到诊断治疗双重目的,诊断输卵管通畅性较准确,而且该检测方法具有操作简便、安全可靠、损伤性小、费用低廉、可重复性强、实用等优点,因此可作为不孕门诊病人的首选检查方法和初步筛选性诊治手段,在不孕症的鉴别诊断和病因诊断方面亦具有很大的临床价值,非常值得各级医院推广应用。
Objective To sdudy the clinical evaluation of diagnosing the passability by utilizing sonosalpingography of physiological saline and transvaginal ultrasonography infertile women.Methods The liquid complex was injected into the uterine cavity of the 284 infertile women. Hydrotubation were performed under the quid of B-mode ultrasongraphy. The following contents were observed: The ovduct internal diameter, shape, flowing speed of gas and liquid, seperated width of darkened liquid shadow of uterine cavity. Amount of liquid around the dnexa and uterus, injecting resistance and pationts'feeling ect. Results 284 pationts were observed: 35 cases with one side partially passable and the other side smoothly passable, 24 cases with one side passable and the other side impassable, 97 cases with both sides passable, 28cases with both sides impassable, 36 cases with one side impassable and the other side partially passable , 64 cases with both sides partially passable, 87 cases were pregnant 4 year after the operation. Conclusions Under the guid of the B-mode ultrasonographyhydrotubation is useful in diagnosis and treatment in infertile women. This method takes the advantages of accuracy, security, easy operation and practical . It should be the first choice in tube passable test of Infertility.
引文
1.曹泽毅主编.中华妇产科学.第1版.北京:人民卫生出版,1996.2313.
2.苏应宽,陈子江.不孕症.中级医刊,1994,29(9):2.
3.刘培淑,等.女性不孕的病因及诊治进展.生殖与避孕,1996,16(4):308.
4.吴玉英,冯缵冲.输卵管检查和疏通术的进展.生殖与避孕,1995,15(6):407～410.
5.杨丹,雷贞武.输卵管不孕的病因.实用妇产科杂志,1996,12:282～284.
6.王秘林,于飞,王莉娟,等.输卵管原因导致不孕的诊断进展.齐齐哈尔医学院学报,2003,24(6):697～698.
7.高巍,吴明辉.输卵管性不孕症的病因及诊断治疗的研究进展.北京医学,2002,24(4):275～277.
8.刘玉沛.输卵管性不孕的诊治.浙江医科大学学报.1996.6(18):241.
9.乐杰主编.妇产科学[M].第4版.北京:人民卫生出版社,1999.371
10.邹荣莉,于翠革,秦民惠,等.B超监视下输卵管通液术的诊断治疗观察.中国医学影像技术.1999.7(15):556～558.
11. Peters AJ, Coulam CB. Hysterosalpingography with color Doppler ultrasonography. Am J Ob-stet Gynecol, 1991, 164(6): 1530.
12. Allahbadia GN. Colour coded duplex sonography for the assessment of fallopian tube patency. Ann Acad Med Singapore, 1994, 23 (1): 98.
13.王益明,巩秀玲,吕秀英等.B超监测下输卵管通液治疗不孕症.山东医药.1999.21(39):181.
14.耿俐,马俊英.B超监视下行子宫输卵管通液的体会.西北国防医学杂志.1998.1(19):58.
15.于翠莉,秦民惠,彭如林,等.B超监视输卵管通液术的诊断治疗光观察.中国医学影项技术,1999,15(7):556～558.
16.曹玉慧,曹建兰.B超监测下行输卵管通液术.现代妇产科进展.1996.1(5):78.
17.叶蓉华,贾同莉,刘朝晖,等.超声下输卵管通液的临床应用价值.中国实用妇科与产科杂志,2001,17(5):303～304.
18.杨履端,于陆琼,超声下输卵管通液的临床应用价值,甘肃科技-医学研究,2002,5:48.
19.徐金霞,蒋晓莉,岳锦春.声学造影诊断180例输卵管性不孕的评价.实用妇
2.苏应宽,陈子江.不孕症.中级医刊,1994,29(9):2.
3.刘培淑,等.女性不孕的病因及诊治进展.生殖与避孕,1996,16(4):308.
4.吴玉英,冯缵冲.输卵管检查和疏通术的进展.生殖与避孕,1995,15(6):407～410.
5.杨丹,雷贞武.输卵管不孕的病因.实用妇产科杂志,1996,12:282～284.
6.王秘林,于飞,王莉娟,等.输卵管原因导致不孕的诊断进展.齐齐哈尔医学院学报,2003,24(6):697～698.
7.高巍,吴明辉.输卵管性不孕症的病因及诊断治疗的研究进展.北京医学,2002,24(4):275～277.
8.刘玉沛.输卵管性不孕的诊治.浙江医科大学学报.1996.6(18):241.
9.乐杰主编.妇产科学[M].第4版.北京:人民卫生出版社,1999.371
10.邹荣莉,于翠革,秦民惠,等.B超监视下输卵管通液术的诊断治疗观察.中国医学影像技术.1999.7(15):556～558.
11. Peters AJ, Coulam CB. Hysterosalpingography with color Doppler ultrasonography. Am J Ob-stet Gynecol, 1991, 164(6): 1530.
12. Allahbadia GN. Colour coded duplex sonography for the assessment of fallopian tube patency. Ann Acad Med Singapore, 1994, 23 (1): 98.
13.王益明,巩秀玲,吕秀英等.B超监测下输卵管通液治疗不孕症.山东医药.1999.21(39):181.
14.耿俐,马俊英.B超监视下行子宫输卵管通液的体会.西北国防医学杂志.1998.1(19):58.
15.于翠莉,秦民惠,彭如林,等.B超监视输卵管通液术的诊断治疗光观察.中国医学影项技术,1999,15(7):556～558.
16.曹玉慧,曹建兰.B超监测下行输卵管通液术.现代妇产科进展.1996.1(5):78.
17.叶蓉华,贾同莉,刘朝晖,等.超声下输卵管通液的临床应用价值.中国实用妇科与产科杂志,2001,17(5):303～304.
18.杨履端,于陆琼,超声下输卵管通液的临床应用价值,甘肃科技-医学研究,2002,5:48.
19.徐金霞,蒋晓莉,岳锦春.声学造影诊断180例输卵管性不孕的评价.实用妇