尼泊尔不孕妇女中通过子宫输卵管造影术检测输卵管异常情况

Detection of tubal abnormalities by HSG in Nepalese subfertile women.

作者信息

Shrivastava V R, Rijal B, Shrestha A, Shrestha H K, Tuladhar A S

机构信息

Department of Gynaecology, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal.

出版信息

Nepal Med Coll J. 2009 Mar;11(1):42-5.

PMID:19769237

Abstract

Fallopian tube defects are responsible for subfertility in 12.0-33.0% of subfertile couple. Hysterosalpingography (HSG) is a safe and less invasive method of detecting both the tubal and uterine defects. The objective of this study was to find out the incidence of tubal blockage including its site and side diagnosed by HSG in subfertile Nepalese women and to find out the incidence of uterine and other abnormalities detected by this test. This was a prospective study of 1000 cases of subfertility, conducted in Om Hospital, Kathmandu. A short history and HSG report of these cases were obtained from the Radiology department of the hospital. Size and shape of the uterine cavity, evidence of cervical incompetence, tubal visualization, spillage of dye, tubal block with its side and site, evidence of peritoneal adhesion and intravasation of dye in vessels were noted. Quick spillage of the dye in the peritoneal cavity or spillage only after pushing the dye with pressure was also noted. Results were entered in simple tabulations and analyzed. Among 1000 cases, 65.8% had primary and 34.2% had secondary subfertility. 29.0% of the total 1000 cases had abnormal HSG findings. 19.0% of total 1000 cases had tubal blockage. Incidence of tubal blockage in both primary (19.1%) and secondary subfertilty (18.7%) was almost same, in contrary to previous belief. Mullerian defect was present in 3.2% of primary subfertility and 2.0% of secondary subfertility cases. Cervical incompetence was not detected in any case. Evidence of uterine infection was present in 0.7% of primary subfertility and 0.2% of secondary subfertility cases. Abnormal size of uterine cavity was present in 1.2% of primary subfertility and 0.5% of secondary subfertility. Features of phimosis of fimbrial opening, localized spill and intravasation of dye were present respectively in 5.6%, 1.5%, 1.2% in primary subfertility and 4.9%, 1.7% and 1.7% in secondary subfertility.In conclusion; the incidence of tubal blockage detectable by HSG in this study was 19.0%.

摘要

输卵管缺陷导致12.0%-33.0%的不育夫妇出现生育能力低下的情况。子宫输卵管造影术（HSG）是一种检测输卵管和子宫缺陷的安全且侵入性较小的方法。本研究的目的是找出尼泊尔不育女性中经HSG诊断的输卵管堵塞的发生率，包括其部位和侧别，并找出通过该检查检测出的子宫及其他异常情况的发生率。这是在加德满都奥姆医院对1000例不育病例进行的一项前瞻性研究。从医院放射科获取了这些病例的简要病史和HSG报告。记录了子宫腔的大小和形状、宫颈机能不全的证据、输卵管显影情况、造影剂溢出情况、输卵管堵塞的侧别和部位、腹膜粘连的证据以及造影剂在血管内的渗漏情况。还记录了造影剂在腹腔内的快速溢出或仅在加压推注造影剂后才溢出的情况。结果以简单表格形式录入并进行分析。在1000例病例中，65.8%为原发性不育，34.2%为继发性不育。1000例病例中共有29.0%的HSG检查结果异常。1000例病例中共有19.0%存在输卵管堵塞。原发性不育（19.1%）和继发性不育（18.7%）中输卵管堵塞的发生率几乎相同，这与之前的看法相反。苗勒氏管缺陷在原发性不育病例中占3.2%，在继发性不育病例中占2.0%。在任何病例中均未检测到宫颈机能不全。子宫感染的证据在原发性不育病例中占0.7%，在继发性不育病例中占0.2%。子宫腔大小异常在原发性不育病例中占1.2%，在继发性不育病例中占0.5%。原发性不育中伞端开口狭窄、局部溢出和造影剂渗漏的特征分别占5.6%、1.5%、1.2%，继发性不育中分别占4.9%、1.7%和1.7%。总之，本研究中经HSG可检测出的输卵管堵塞发生率为19.0%。