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目的提高子宫输卵管造影中诊断输卵管近端梗阻的准确性。方法选择600例生殖医学中心的不孕受检者,年龄21～45岁,平均年龄34岁。随机分成A、B、C、D 4组,A组222例444条输卵管,B组121例242条输卵管,C组135例270条输卵管,D组122例244条输卵管。在实时透视下行子宫输卵管优维显造影,分析输卵管造影中近端输卵管梗阻的假阳性因素。结果导管顶端位于输卵管开口处121例,其中98例(80.99%)导致同侧宫角及输卵管不显影;经适当外拉或旋转导管后112例(92.56%)同侧宫角显影,其中84例(69.42%)同侧输卵管近端显影,仅有37例为近端输卵管梗阻。因球囊过大或过小导致造影剂未能充盈宫角者135例,其中78例(57.78%)单侧近端输卵管不能显影,经调整后59例(43.70%)单侧输卵管近端显影,仅19例为单侧近端输卵管梗阻。122例受检者仅以盆腔正位观察,有48例(39.34%)单侧输卵管近端不能显影,改变体位后35例(28.69%)近端输卵管得以显影。4组子宫输卵管造影中,B、C、D 3组输卵管近端梗阻率均低于A组常规输卵管造影,D组输卵管梗阻率明显低于前3组。结论在透视下行子宫输卵管造影,能及时判断造成近端输卵管不显影的假阳性因素并及时纠正,可直接提高输卵管显影率及诊断准确性。
Objective To improve the accuracy of diagnosis of tubal proximal obstruction in uterine tubal angiography. Methods Infertility subjects of 600 reproductive medical centers were selected, aged from 21 to 45 years with a mean age of 34 years. Randomly divided into A, B, C and D 4 groups. A group of 222 patients with 444 fallopian tubes, B group 121 with 242 fallopian tubes, 135 patients with 270 cases of fallopian tubes in Group C, and 122 patients with 244 fallopian tubes in group D. In real-time perspective of the uterine tubal uvula Wei-dimensional contrast imaging, analysis of tubal proximal tubal obstruction in the false-positive factors. Results The top of the catheter was located at the opening of the fallopian tube in 121 cases, of which 98 cases (80.99%) led to ipsilateral cornual and tubal non-visual development; 112 cases (92.56%) developed ipsilateral cornices by appropriate external pulling or rotating catheter, 84 (69.42%) ipsilateral fallopian tube proximal development, only 37 cases of proximal tubal obstruction. One hundred and thirty-five cases were diagnosed as having failed to fill the corner with contrast medium due to too large or too small balloon. Among them, 78 (57.78%) unilateral proximal tubal could not be developed. After adjustment, 59 cases (43.70%) unilateral tubal proximal development , Only 19 cases of unilateral proximal tubal obstruction. In 122 cases, only the pelvic anteroom was observed, 48 cases (39.34%) unilateral tubal proximal can not develop, 35 cases (28.69%) change the position of the fallopian tube to develop. In the 4 groups of hysterosalpingography, the proximal tubal obstruction rates in groups B, C and D 3 were lower than those in group A, and the tubal obstruction in group D was significantly lower than that of the former three groups. Conclusions In the perspective of hysterosalpingography, the false positive factors that cause the proximal tubal non-visualization can be judged in time and corrected in time, which can directly improve the oviduct development rate and diagnostic accuracy.