Karande V C, Pratt D E, Rao R, Balin M, Gleicher N
Center for Human Reproduction, Chicago, Illinois 60610, USA.
Fertil Steril. 1995 Dec;64(6):1070-3. doi: 10.1016/s0015-0282(16)57962-x.
To investigate the possible etiologies of elevated tubal perfusion pressures.
Analysis of 48 consecutive female patients with infertility who underwent laparoscopy and a gynecoradiological investigation as part of their infertility work-up.
Academically affiliated infertility center.
A gynecoradiological investigation was performed using a previously reported standardized contrast injection system. Laparoscopy was performed routinely.
Patients who demonstrated by laparoscopy to have endometriosis showed a significantly increased incidence of tubal blockage during initial hysterosalpingography (HSG) (12/26, 46.1%) compared with controls (2/14, 14.3%). Patients with endometriosis also demonstrated significantly more frequently elevated tubal perfusion pressures (22/26; 84.6%) than women without disease (2/14, 14.3%) and significantly higher mean tubal perfusion pressures than women with normal pelvises (576 +/- 264 versus 450 +/- 268 mm Hg).
Tubal blockage during initial HSG and elevated tubal perfusion pressures during selective salpingography are highly suggestive of tubal endometriosis. These data are the first evidence that tubal involvement with endometriosis may be more frequent than previously suspected. They also suggest that the performance of a gynecoradiological investigation, inclusive of selective salpingography, can greatly contribute to a presumptive diagnosis of endometriosis.
探讨输卵管灌注压升高的可能病因。
对48例连续的不孕女性患者进行分析，这些患者接受了腹腔镜检查和妇科放射学检查，作为其不孕检查的一部分。
学术附属不孕中心。
使用先前报道的标准化造影剂注射系统进行妇科放射学检查。常规进行腹腔镜检查。
与对照组（2/14，14.3%）相比，腹腔镜检查显示患有子宫内膜异位症的患者在初次子宫输卵管造影（HSG）期间输卵管阻塞的发生率显著增加（12/26，46.1%）。与未患该病的女性（2/14，14.3%）相比，子宫内膜异位症患者输卵管灌注压升高的频率也显著更高（22/26；84.6%），且平均输卵管灌注压显著高于盆腔正常的女性（576±264对450±268mmHg）。
初次HSG期间的输卵管阻塞和选择性输卵管造影期间的输卵管灌注压升高高度提示输卵管子宫内膜异位症。这些数据是首个证据，表明输卵管受子宫内膜异位症累及可能比先前怀疑的更为常见。它们还表明，包括选择性输卵管造影在内的妇科放射学检查的实施，可极大地有助于子宫内膜异位症的初步诊断。
