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題 名 | Diagnostic and Therapeutic Value of Nonhysteroscopic Transvaginal Falloposcopy with a Linear Everting Catheter=經陰道使用帶線型外翻導管輸卵管鏡在輸卵管疾病的診斷和治療中的價值 |
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作 者 | 李國光; | 書刊名 | 中華醫學雜誌 |
卷 期 | 61:12 1998.12[民87.12] |
頁 次 | 頁721-725 |
分類號 | 417.14 |
關鍵詞 | 輸卵管鏡; 輸卵管阻塞; Falloposcope; Tubal occlusion; |
語 文 | 英文(English) |
中文摘要 | 背景 在輸卵管鏡發明以前,對於輸卵管內的病變無法以內視鏡做檢查。輸卵管的 通暢與否和管內上皮細胞的健康狀況,對於早期胚胎在輸卵管內的傳送與發育非常重要。 方法以子宮輸卵管攝影術診斷為輸卵管阻塞的20位病人中,包括10例輸卵管水腫,5例 輸卵管近端阻塞和5例繖部阻塞。腹腔鏡手術和帶線型外翻導管的輸卵管鏡手術同時進行, 以便評估輸卵管的內腔和輸卵管旁的狀況。 結果我們不需借助子宮腔鏡而僅用輸卵管鏡經由線型外翻導管來檢查20位病人的30條輸 卵管。30條輸卵管中有24條(80%)壺部上皮細胞可以清楚地檢查,但是有4條(1 3%)只能檢查到近端的輸卵管內腔,成功的套管率為93%(28╱30)。在15例的 輸卵管水腫和繖部阻塞的病人中,10位病人(67%)因為輸卵管內黏連和黏膜扁平而建 議其採用體外受精和胚胎植入術。只有4位病人(29%)的輸卵管內黏膜正常而適合接受 輸卵管整形手術。最後一位病人(6%)經過檢查後證實輸卵管通暢而且黏膜正常。5例輸 卵管近端阻塞的病人中有2例曾經2次施行通水術失敗,但以線型外翻導管卻能打通輸卵管 近端的阻塞。30例中只有1例輸卵管外周嚴重黏連,導致壺部的輸卵管壁被輸卵管鏡穿透 。 結論輸卵管鏡術是一種檢查和評估輸卵管內腔病極具價值的技術,醫生可以依據檢查的結果 而建議病人選擇正確的治療。關於輸卵管近端的阻塞,輸卵管鏡術也有打通阻塞的效果。 |
英文摘要 | Background. Before the advent of the falloposcope, the endosalpinx usually evaded endoscopic evaluation. The healthy condition of the tubal epithelium and the patency of the tube are important for development and transportation of early stage embryos. Methods. Twenty patients had tubal occlusion diagnosed by hysterosalpingography, including 10 cases of hydrosalpinx, five cases of interstitial occlusion and five cases of fimbrial occlusion. Falloposcopy with a linear everting catheter and laparoscopy were performed simultaneously to evaluate tubal lumens and peritubal conditions. Results. An attempt was made to cannulate 30 fallopian tubes in 20 cases with a falloposcope, using a nonhysteroscopic transvaginal approach through a linear everting catheter. The success rate was 93% (28/30). In 15 cases of hydrosalpinx or fimbrial obstruction, 10 patients (67%) were considered to be suitable for in vitro fertilization because of flattened mucosa in the endosalpinx and endotubal adhesions. Normal mucosa was noted in only four patients (27%), who were advised to have tuboplasty. One patient (6%) had normal mucosa without tubal occlusion. In two of the five cases of interstitial occlusion, dye (methylene blue) could not pass the interstitial portion of the fallopian tube when chromopertubation was performed twice. This tubal obstruction was overcome with the linear everting catheter. One patient had the complication of an ampulla wall perforation. Conclusions. In patients with fallopian tube disease, falloposcopy is a useful technique for evaluating the endosalpinx and providing information for selecting further treatment. In some cases of interstitial occlusion, it may also have a therapeutic effect. |
本系統中英文摘要資訊取自各篇刊載內容。