宫腔镜输卵管插管术治疗输卵管间质部阻塞性不孕症514例临床分析

目的:探讨宫腔镜输卵管插管术对输卵管间质部阻塞的治疗效果。方法:1998年5月～2007年5月输卵管间质部阻塞性不孕患者514例,行宫腔镜输卵管插管术,记录输卵管的疏通情况。结果:60.2%输卵管开口清晰可见,35.0%输卵管开口闭锁。双侧输卵管间质部阻塞的患者治疗1次的通畅率为39.6%,累积通畅率为74.2%,单侧输卵管间质部阻塞的患者治疗1次的通畅率为50.4%,累积通畅率为80.0%。一侧输卵管间质部阻塞而对侧输卵管通畅的患者治疗1次后输卵管的通畅率明显高于双侧输卵管间质部阻塞和一侧输卵管间质部阻塞而对侧输卵管其他部位阻塞的患者。不同的不孕类型、不孕年限和年龄的患者治疗效果无差别。结论:对于子宫输卵管造影检查诊断为输卵管间质部阻塞的患者,建议先行宫腔镜输卵管插管术,排除造影结果的假阳性,同时能对大部分患者起到疏通治疗的作用。

Clinical analysis on 514 infertile women with interstitial tubal occlusion treated with hysteroscopic tubal catheterization

Objective:To explore the therapeutic effect of hysteroscopic tubal catheterization on interstitial tubal occlusion.Methods:514 infertile women of interstitial tubal occlusion underwent hysteroscopic tubal catheterization from May 1998 to May 2007,and the therapeutic effect was recorded.Results:60.2% of the tubal orifice was clear,while 35.0% of the tubal orifice was atretic. The effective rate of bilateral interstitial tubal occlusion after once treatment was 39.6%,while the cumulative effective rate was 74.2%. The effective rate of unilateral interstitial tubal occlusion after once treatment was 50.4%,while the cumulative effective rate was 80.0%. The effective rate after once treatment was significantly higher in patients of unilateral interstitial tubal occlusion while contralateral tubal smooth than that in patients of bilateral interstitial tubal occlusion and unilateral interstitial tubal occlusion while contralateral tubal occlusion at other positions.There was no difference in therapeutic effect between different infertile types,duration times of infertility and ages of patients.Conclusion:Hysteroscopic tubal catheterization is recommended for the infertile patients with interstitial tubal occlusion,in order to exclude the false positive results of hysterosalpingography.It is effective for the major patients with interstitial tubal occlusion.