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guidelines for Treatment of Tubal Infertility-Tubal Infertility

guidelines for Treatment of Tubal Infertility-Tubal Infertility
Tubal infertility treatment compass to the fallopian tube infertility patients to the hospital often appear questions to answer, for example: Tubal infertility hanging what department number? What should I pay attention to before examination of tubal infertility? What do doctors usually ask? What tests should tubal infertility do? What do you think of the results of tubal infertility examination? Wait. The purpose of the guide is to facilitate the treatment of patients with tubal infertility and solve the doubts of patients with tubal infertility.
Typical symptom
Menstrual disorder, excessive menstruation and secondary infertility
Suggested visiting department
Reproductive health, traditional Chinese medicine
Best visit time
No special, see a doctor as soon as possible
Duration of visit
One day is reserved for the first visit, and half a day is reserved for the second visit
Frequency of follow-up visit/diagnosis and treatment cycle
Outpatient treatment: After weekly follow-up until menstrual volume is stable, follow-up is uncomfortable. Severe cases need to be admitted to hospital for treatment. After abdominal pain disappears, they will be transferred to outpatient
Preparation before seeing a doctor
No special requirements, pay attention to rest.
Common consultation contents
1. Describe the reason for seeing a doctor (when did you start and what's wrong?)
2. Is the feeling of discomfort caused by obvious factors?
3. Have irregular menstruation, abdominal pain and other accompanying symptoms?
4. Have you been to the hospital, have you done those examinations, and what are the examination results?
5. How is the treatment?
6. Is there any history of drug allergy?
Key inspection items
1. Tubal patency examination
Tubal patency examination is a method to check whether fallopian tubes are unobstructed. Generally, after disinfection through vagina and cervix, special medical instruments or appliances are selected to inject liquid, air or drugs into uterus through cervix to determine whether fallopian tubes are unobstructed.
2. Infertility testing
There are many specific examination items for infertility examination. Fourteen examinations for men: urethra examination, prostate examination, seminal vesicle vas deferens examination, epididymis examination, testicular examination, sex hormone examination, sexual function examination, reflex motor function examination, immune factor examination, endocrine examination, varicocele examination, trauma examination, radiation factor examination and sperm quality examination. Thirteen examinations for women: vaginal examination, cervical examination, uterine examination, fallopian tube examination, ovarian examination, pelvic examination, endocrine examination, sex hormone examination, immune factor examination, systemic factor examination, mental factor and psychological factor examination, congenital factor examination, ovulation function examination, ultrasonic B-ultrasound examination and four routine examinations.
3. X-ray lipiodol radiography
Lipiodol radiography is an X-ray hysterosalpingography with iodized oil as contrast medium. Tubal lipiodol radiography is an examination method that injects iodized oil contrast agent into uterine cavity and fallopian tube through catheter, performs X-ray fluoroscopy and photographing by X-ray diagnostic instrument, and knows whether fallopian tube is unobstructed, blocked position and uterine cavity shape according to the development of contrast agent in fallopian tube and pelvic cavity.
Diagnostic criteria
Tubal infertility examination technology is a rough examination method, and the results are not very accurate. It is impossible to judge whether the fallopian tube is unobstructed on one side or both sides when it shows that the fallopian tube is unobstructed. Sometimes, when the tissues around the distal end of the fallopian tube are partially adhered, although it shows that the fallopian tube is still unobstructed, it also affects pregnancy; When hydrosalpinx, it can also contain more than 20ml of liquid and produce illusion; Moreover, it is blindness to judge only by the operator's feeling whether there is resistance when injecting liquid and whether the patient has abdominal pain; There is a danger of gas embolism when gas enters blood vessels during ventilation. Therefore, these two methods to check the patency of fallopian tubes have been basically not used, and the fluid-passing operation is still used as a treatment method because of its certain therapeutic effect on salpingitis. The examination results of HSG are reliable and non-invasive, Is a simple and widely used method for examining uterine and fallopian tubes, With the help of HSG, we can judge the position of uterus, the shape of uterine cavity, the condition of endometrium, the shape of fallopian tube, the condition of endometrium of fallopian tube and whether the lumen is unobstructed. We can also know whether there is adhesion around the distal end of fallopian tube according to the diffusion degree of contrast medium in pelvic cavity, and have certain therapeutic effect on mild inflammation and adhesion of fallopian tube. With the development of ultrasonic diagnostic technology, ultrasound-guided tubal fluidization has been widely used in clinic. It has good sensitivity and specificity in detecting tubal patency, and its advantages are simple operation, safety, non-invasive, less time-consuming, free from the influence of radiation, and dynamic continuous repeated detection. The liquid used is warm normal saline plus gentamicin, dexamethasone, alpha-chymotrypsin and lidocaine, After the patient underwent fluid drainage, B-ultrasound takes the best section to observe the filling situation of uterus, whether there is dynamic liquid sound image spreading to both sides in the horns of uterus on both sides, According to the shunt and accumulation of fluid in uterine cavity, the patency of fallopian tube can be accurately diagnosed by the images of fallopian tube, the effusion of adnexal area and uterine rectal fossa, and the clinical judgment of resistance and reflux during injection. The method of hysterosalpingography is the same as that of tubal ultrasound patency test, except that 1.5% hydrogen peroxide is added to the liquid used for fluid passageContrast medium is injected into uterine cavity, and dynamic images of fluid and gas filling in uterine cavity, operation through fallopian tube and overflow of microbubbles are observed by ultrasound, which can accurately judge the patency of fallopian tube, and make clear the patency or non-patency of fallopian tube side, and sometimes observe the change process from obstruction to patency. Therefore, hydrogen peroxide salpingography can improve the diagnostic accuracy of tubal patency and obstruction site.


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