Jessup M J, Grainger D A, Kluzak T R, Webster B W
Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Wichita.
Obstet Gynecol. 1993 May;81(5 ( Pt 1)):732-5.
To compare the ability of four chromotubation techniques to generate and maintain intrauterine pressures in the diagnosis of proximal tubal obstruction.
Sixteen extirpated uteri were used for this study. A pressure catheter was placed through the fundus into the endometrial cavity. Three cannulas were evaluated: 1) the Cohen cannula with hold and no-hold techniques, 2) the BARD cervical cannula (dual intrauterine and intracervical balloons), and 3) the Harris-Kronner uterine manipulator-injector catheter with an intrauterine balloon. Intrauterine pressures were monitored while warm saline was infused. The studies were performed with the tubes obstructed, and measurements of peak attainable intrauterine pressures were recorded. Data were analyzed by t test, with significance set at P < .05.
Peak intrauterine pressures for the four groups were as follows: 1) Cohen cannula, not holding, 40.7 +/- 5.1 mmHg; 2) Cohen cannula, holding in place, 63.6 +/- 5.3 mmHg; 3) BARD cannula, 112.4 +/- 3.5 mmHg; and 4) Harris-Kronner cannula, 106.3 +/- 4.3 mmHg. The BARD and Harris-Kronner cannulas achieved significantly higher intrauterine pressures than either method of using the Cohen cannula (P < .001). There was no statistically significant difference between the BARD and Harris-Kronner cannulas.
Significant differences in achievable intrauterine pressures were demonstrated among catheters in our in vitro model. Based on these findings, we believe that the BARD, Harris-Kronner, or other intrauterine balloon-type cannula should be used before diagnosing proximal tubal obstruction.
比较四种输卵管插管技术在诊断近端输卵管阻塞时产生并维持宫腔内压力的能力。
本研究使用了16个切除的子宫。将一根压力导管经子宫底部置入子宫内膜腔。对三种插管进行了评估：1）采用握持和非握持技术的科恩插管；2）巴德宫颈插管（子宫内和宫颈内双球囊）；3）带有子宫内球囊的哈里斯-克朗纳子宫操纵器-注射器导管。在输注温盐水时监测宫腔内压力。在输卵管阻塞的情况下进行研究，并记录可达到的宫腔内压力峰值。数据采用t检验进行分析，显著性设定为P < 0.05。
四组的宫腔内压力峰值如下：1）非握持状态下的科恩插管，40.7±5.1 mmHg；2）固定在位的科恩插管，63.6±5.3 mmHg；3）巴德插管，112.4±3.5 mmHg；4）哈里斯-克朗纳插管，106.3±4.3 mmHg。巴德插管和哈里斯-克朗纳插管所达到的宫腔内压力显著高于使用科恩插管的任何一种方法（P < 0.001）。巴德插管和哈里斯-克朗纳插管之间无统计学显著差异。
在我们的体外模型中，不同导管在可达到的宫腔内压力方面存在显著差异。基于这些发现，我们认为在诊断近端输卵管阻塞之前应使用巴德插管、哈里斯-克朗纳插管或其他子宫内球囊型插管。
