Deaton J L, Gibson M, Riddick D H, Brumsted J R
University of Vermont, College of Medicine, Department of Obstetrics and Gynecology, Burlington 05405.
Fertil Steril. 1990 Feb;53(2):232-6. doi: 10.1016/s0015-0282(16)53272-5.
Proximal tubal obstruction, either unilateral or bilateral, is a frequent finding on hysterosalpingogram (HSG). Approximately two-thirds of the fallopian tubes resected for proximal tubal obstruction reveal an absence of luminal occlusion. The distinction between true pathologic occlusion and either spasm or plugging is crucial in determining therapy. We combined hysteroscopic cannulation of the proximal fallopian tube with laparoscopy in 11 patients with proximal tubal obstruction diagnosed by HSG and confirmed at laparoscopy. Hysteroscopic cannulation was able to be performed in 72% of the fallopian tubes attempted, and there was a postcannulation patency rate by HSG of 73%. Six of the 11 patients became pregnant after tubal cannulation and adjunctive distal tubal surgery. Hysteroscopic cannulation of the fallopian tube is a safe diagnostic procedure that can be used to identify those patients with true proximal occlusion, and may also serve as a therapeutic procedure in some of these patients.
近端输卵管阻塞，无论是单侧还是双侧，在子宫输卵管造影（HSG）检查中都很常见。因近端输卵管阻塞而切除的输卵管中，约三分之二显示管腔无闭塞。在确定治疗方案时，区分真正的病理性闭塞与痉挛或堵塞至关重要。我们对11例经HSG诊断为近端输卵管阻塞并经腹腔镜检查证实的患者，采用宫腔镜下近端输卵管插管联合腹腔镜手术。在尝试插管的输卵管中，72%能够成功进行宫腔镜插管，插管后HSG显示通畅率为73%。11例患者中有6例在输卵管插管及辅助性远端输卵管手术后怀孕。宫腔镜下输卵管插管是一种安全的诊断方法，可用于识别真正近端闭塞的患者，在部分此类患者中也可作为一种治疗方法。
