子宫输卵管造影显示输卵管近端阻塞行宫腹腔镜联合手术118例结果分析

发布时间：2018-04-30 12:57

本文选题：输卵管近端阻塞 + 子宫内膜异位症　；参考：《实用妇产科杂志》2015年03期

【摘要】：目的:探讨子宫输卵管造影(HSG)提示的输卵管近端阻塞患者的盆腔病变特征。方法:选择2011年5月至2013年5月行HSG提示输卵管近端阻塞性不孕并行宫腹腔镜联合手术(腹腔镜下输卵管通液术及宫腔镜下输卵管插管术)患者118例,根据术后结果分为假阳性组(50例)、插管通畅组(50例)和插管失败组(18例),比较3组间合并盆腔子宫内膜异位症(内异症)、盆腔非内异症炎性粘连及输卵管远端微小病变的比例。结果:HSG诊断近端阻塞假阳性率为42.4%(50/118)。假阳性组及插管通畅组合并盆腔内异症的比例(68.0%,52.0%)明显高于插管失败组(5.6%);合并输卵管远端微小病变的比例(30.0%,14.0%)明显高于插管失败组(0);而合并盆腔非内异症炎性粘连的比例(18.0%,28.0%)则明显低于插管失败组(66.7%),差异均有统计学意义(P0.01)。结论:HSG提示输卵管近端阻塞但为假阳性时,可能为暂时性管腔阻塞,多合并盆腔内异症,内异症微小病变可能是导致输卵管各部位功能障碍的原因;而输卵管近端真性阻塞为永久性管腔闭锁,多合并盆腔的慢性炎症。
[Abstract]:Objective: to investigate the characteristics of pelvic lesions in patients with proximal tubal obstruction indicated by hysterosalpingography (HSG). Methods: from May 2011 to May 2013, 118 patients with proximal oviduct obstructive infertility and combined hysteroscopy with hysteroscopic tubal intubation or hysteroscopic tubal intubation were selected. According to the postoperative results, the patients were divided into false positive group (n = 50), intubation patency group (n = 50) and failed intubation group (n = 18). Results the false positive rate of 10% HSG in proximal obstruction was 42.4% / 118%. The proportion of false positive group and intubation unobstructed combination with pelvic heterosis was significantly higher than that of failed intubation group (68.0%, 52.0%); the proportion of patients with tubal microlesion was 30.0% and 14.0%; and the rate of pelvic non-endodysm inflammatory adhesion was significantly higher than that of intubation failure group (30.0%, 14.0%), while the rate of pelvic non-endodymal inflammatory adhesions was significantly higher than that of the group with failure of intubation. The ratio of 18.0% to 28.0% was significantly lower than that of the failed intubation group (P 0.01). Conclusion when the proximal oviduct is obstructed but false positive, it may be a temporary lumen obstruction, and most of them are complicated with pelvic heterosis, and the minor changes of endometriosis may be the cause of the dysfunction of the fallopian tube. The true obstruction of the proximal oviduct was permanent atresia of the lumen, with chronic inflammation of the pelvic cavity.
【作者单位】：北京大学人民医院;
【分类号】：R713.7;R816.91

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