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目的探讨宫腔镜下输卵管通液术的应用。方法选择2009年4月至2010年4月就诊于四平市中心人民医院的女性不孕症患者68例,均在宫腔镜直视下输卵管间质部插管加压通液术,观察输卵管通畅率及受孕率。结果 68例不孕症患者检查中,双侧输卵管通畅者占12例;单侧输卵管通而不畅者38例,占56%;双侧输卵管通而不畅者8例,占12%;双侧输卵管梗阻者5人,占13%;宫腔粘连2例;子宫畸形1例;黏膜下肌瘤1例;子宫内膜钙化1例。宫腔镜通液术检查单侧输卵管通而不畅者38例,经插管反复加压后27人完全通畅(占71%),经2次通液后又有6人完全通畅,共占81%,双侧输卵管通而不畅者8例,经插管反复加压后4人完全通畅。双侧输卵管梗阻者5人,经2次通液及中药治疗后,有2人达到通而不畅的结果。对本组患者均跟踪随访,总计已怀孕14人,自然流产2人,异位妊娠1人,术后怀孕时间最早2个月,其余病例仍在治疗与观察中。结论在宫腔镜直视下,将导管插入宫角部输卵管开口处,减少了传统方法的盲目性,起到机械性疏通作用,再加上直接加压于输卵管内部粘连起到分解作用,并辅以药物治疗,故达到较理想的治疗目的。
Objective To investigate the application of hysteroscopic tubal fluidization. Methods Sixty-eight female infertility patients who visited the People’s Hospital of Siping City Center from April 2009 to April 2010 were selected and underwent hysterosalpingography under the guidance of hysteroscopy to observe the tubal patency Rate and pregnancy rate. Results 68 patients with infertility examination, bilateral tubal patency in 12 cases; unilateral tubal and poor in 38 cases, accounting for 56%; bilateral tubal and poor in 8 cases, accounting for 12%; double 5 cases of lateral tubal obstruction, accounting for 13%; 2 cases of intrauterine adhesions; 1 case of uterine malformations; 1 case of submucous myoma; 1 case of endometrial calcification. Hysteroscopic examination of unilateral tubal unobstructed 38 cases of unilateral, repeated after intubation 27 people were completely smooth (71%), after 2 times the fluid and 6 were completely clear, a total of 81%, bilateral fallopian tube pass and poor in 8 cases, 4 times after intubation repeated pressure completely. Bilateral tubal obstruction in 5, after 2 times through the liquid and Chinese medicine, 2 people to pass the poor results. The patients were followed up for a total of 14 pregnant, 2 spontaneous abortion, 1 ectopic pregnancy, the earliest postoperative pregnancy 2 months, the remaining cases are still under treatment and observation. Conclusions Under the hysteroscopy, the catheter is inserted into the opening of the oviduct at the corner of the horn, reducing the blindness of the traditional method and acting as a mechanism of mechanical dredging. Combined with the direct pressurization of the internal adhesions in the fallopian tube, Supplemented by medical treatment, so to achieve a more ideal therapeutic purpose.