摘要
目的正确评价宫腔输卵管造影对诊断生殖道支原体属感染的有效性,以减少误诊,提高诊断准确率。方法复习64例支原体属感染不孕患者的临床病史、术中表现,同时对宫腔输卵管造影征象进行重点分析、归纳和总结。结果 43例有异常征象,阳性率占67.18%;另21例无明显异常;生殖道支原体属感染的影像表现可归类为:宫腔型:支原体属感染时间短,早期患者可无宫腔输卵管造影异常征象,仅可见造影术中疼痛明显易痉挛6例,当感染进一步发展,造影时可表现为宫腔外形偏小4例,宫腔变形、牵拉固定5例,宫壁边缘毛糙7例,宫腔边缘出现逆流13例占有异常征象的33.33%,宫内粘连、充盈缺损6例,宫角部呈切角样梗阻,单侧12支,双侧5例;输卵管型:以输卵管内膜破坏为主要特点时,造影表现输卵管壁易逆流,输卵管外形纤细、僵硬、管壁不规则及管腔狭窄、不全阻塞或阻塞,输卵管伞部积水等,可见输卵管外形纤细31支,管壁僵硬25支,走行迂曲17支;输卵管阻塞12支,有5例出现输卵管憩室;盆腔炎型:输卵管腔外和或输卵管伞部周围粘连形成,表现输卵管边缘不光整、迂曲及输卵管伞部粘连、积水,盆腔造影剂弥散不均匀等征象,输卵管伞部结构紊乱或消失8支;输卵管伞部位置上移伴粘连10支;伞部呈串珠状改变10支;伞部囊状积水者占16支;盆腔造影剂流动性差、弥散不均21例;混合型:上述3种类型表现兼而有之者31例。结论了解支原体属感染的宫腔输卵管显影征象,有助于结核和其他因素造成的异常改变的鉴别,能佐证病因诊断、减少误诊,提高疾病的正确诊断率,为正确选择治疗方案提供有利价值。
OBJECTIVE To correctly appreciate the effectiveness of intrauterine hysterosalpingography （ HSG ） in the diagnosis of genital Mycoplasma infection so as to reduce misdiagnosis and improve the accuracy of diagnosis. METHODS The clinical history and intranperative performance of 64 cases of infertile patients infected with Mycoplasma were reviewed, at the same time the uterine tubal angiography signs were analyzed and summarized. RESULTS Totally 43 cases had abnormal signs with a percentage of 67.18 being positive, while the rest 21 cases did not have any obvious abnormal signs. The Mycoplasma infections imaging findings could be classified as the uterine type： Mycoplasma infection time was short, and the early patients may not display intrauterine uterine HSG abnormal signs, only pain and spasm were obviously visible in 6 cases; when the infections further developed, angiography may show unsmooth palace wall （7 cases）, contrast agent reflux （13 cases, 33.33%）, the cornual obstruction （4 cases）was Cutaway like the serious visible intrauterine filling defect and intrauterine deformation characteristics （5 cases）. In severe cases, there were visible intrauterine filling defect or intrauterine deformation （6 cases） characterized by the unilateral in 12 pieces and bilateral in 5 cases. Tubal type： the main features were the destruction of the endosalpinx, the radiography showed easy countercurrent of the tubal wall and slender （31 cases） , stiff tubal shape （25 cases）, irregular and stenosis wall （17 cases ） and incomplete obstruction （12 cases） or obstructive hydrocephalus of tubal （5 cases）. Pelvic inflammatory disease type： the tubal extraluminal or tubal around showed that the adhesion formation and tubal edge seemed unsmooth, tortuous and tubal around adhesions, water, pelvic contrast agent dispersed unevenly signs were observed , there were 8 cases with tubal structural disordered or disappearing , 10 cases with shifted tubal and adhesions, 10 cases with the tubal changing like beads , 16 cases with tubal cystic hydrocephalus, and 21 cases with poor fluidity of pelvic contrast agent and uneven disperse. Mixed type： the performance of a combination of the above three types （31 cases）. CONCLUSION Mycoplasma play an important role in corroboration etiological diagnosis, reducing misdiagnosis and improving the rate of correct diagnosis of the disease, which contributes to the correct choice of treatment program.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第6期1380-1382,共3页
Chinese Journal of Nosocomiology
关键词
子宫输卵管造影
女性
生殖道感染
宫颈
分泌物
支原体属
Hysterosalpingography
Female
Reproductive tract infection
Cervix
Secretion
Mycoplasma
