双腔球囊导管子宫输卵管碘水造影的临床应用  

Clinical application of hysterosalpingography with a double-lumen catheter of a contrast media combination consisting iohexol and saline

作　　者：席嘉元[1] 江勇[1] 曹新华[1] 朱瑛[2] 吕梁[1] 赵新湘[1] 卫丁英[2] 邵静宣[2] 华健[1] 

机构地区：[1]云南省第一人民医院放射科,650032 [2]云南省第一人民医院生殖遗传科,650032

出　　处：《介入放射学杂志》2005年第5期501-503,共3页Journal of Interventional Radiology

摘　　要：目的探讨女性不孕症子宫腔输卵管碘水造影诊断的优越性。方法应用双腔球囊导管插入子宫腔,注入2.5～3.5ml生理盐水或空气充盈球囊,使球囊卡于子宫颈峡部,堵住子宫颈内口,用助推器注入碘海醇充盈子宫及输卵管,如遇输卵管阻塞时,可进一步增高宫腔内压力,使造影剂钝性分离,开通阻塞输卵管,整个过程在电视监视下进行,并选择实时摄片。结果本组检查2698例女性不孕患者,插管成功2685例,成功率99.5%。诊断原发不孕806例,继发不孕1868例,其他24例。子宫腔造影:正常2198例(81.9%),各种先天性畸形249例(9.3%),各种后天性病变238例(8.9%),输卵管阻塞3082支。有98例曾在外院作过碘油造影,至今35例输卵管内仍有碘油潴留。输卵管重度积水117支(3.8%)。术中有轻度疼痛,无并发症及死亡。结论该法简便快速,安全有效,图像质量优良,能获得比碘油造影更多的信息。克服了碘油造影不能加压和部分患者输卵管内长期碘油潴留的缺点,值得推广应用。Objective To evaluate the clinical value of hysteosalpingographic diagnosis in infertile women. Methods After a catheter with a double-lumen saccule was inserted into the uterine cavity, saline or air of 2.5-3.5ml was injerted to fill the saceule. The filled saccule was inserted at the isthmus of uterus for blocking the internal orifice. The contrast medium was injected through the catheter into the uterine cavity and fallopian tubes to undertake hysterosalpingography and fallopian tube reopening. In case of fallopian tube obstruction, the injection pressure could be increased to obtain recanalization. All operations and selective imagings were carried out under TV supervision. Results 2698 cases including 806 primary infertile women and 1868 secondary infertile women were examined by this method. Technical success rate was 99.5% with 2 198 cases （81.9%） having normal uterus, 249 （9.3%） congenital abnormal uterus and 238 （8.9%） uterus diseases. The number of obstructed fallopian tube was 3028 with 117 serious hydropsy （3.8%）. Ninety-eight cases had been examined with lipiodol hysterosalpingography in other hospitals with 35 cases still having lipiodol accumulated within the uterine cavities and fallopian tubes. No serious complications or death occurred except slight pain. Conclusions Double-lumen cather with a contrast media combination of iohexol and saline for hysterosal pinography is safe, easy and effective, outcoming with excellent quality images. More information can be gained with this method than traditional lipiodol hyterosalpinography, and furthermore could have compression during radiogrophy and avoid the long term stasis of lipiodal.

关 键 词：子宫 输卵管 碘水造影 双腔球囊导管 子宫输卵管 球囊导管 碘水造影 临床应用 双腔 碘油造影 女性不孕症 输卵管阻塞 子宫腔造影 

分 类 号：R816.91[医药卫生—放射医学]