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【目的】探讨选择性输卵管造影(SSG)及输卵管再通(FTR)术中并发症及预防。【方法】182例不孕症患者行SSG及FTR术,观察术中并发症并及时处理。【结果】122支输卵管行SSG。输卵管积水Ⅰ度患者出现轻度恶心、呕吐(1/49);输卵管积水Ⅱ度患者出现腹胀、恶心、呕吐,出虚汗(3/32),经对症处理均缓解;输卵管积水Ⅲ-Ⅳ度患者,出现严重的血管迷走神经反应(2/15),血压下降至50/20 mmHg,经及时皮下注射阿托品0.5 mg及积极抗休克处理,生命体征恢复正常。236支输卵管行FTR,峡部阻塞出现输卵管穿孔(2/41)。宫角部阻塞出现宫角部内膜损伤(27/195),造影剂在宫角部浓聚成团,其中18例出现子宫静脉显影。出现过敏性皮疹4例,无腹腔出血发生。【结论】SSG中,明确为输卵管积水,进一步加压则应慎重,以预防严重血管迷走神经反应。FTR术中并发症发生率低,输卵管穿孔及宫角部内膜损伤均无需特殊处理,只要严格掌握适应症、操作正规、动作轻柔,为安全的检查和治疗方法。
【Objective】 To explore the complications and prevention of selective salpingography (SSG) and tubal recanalization (FTR). [Methods] 182 infertility patients underwent SSG and FTR surgery to observe intraoperative complications and timely treatment. 【Results】 122 tubal tumors were treated with SSG. Tubal hydronephrosis in patients with mild degree of nausea and vomiting (1/49); hydrosalpinx Ⅱ degree of patients with abdominal distension, nausea, vomiting, sweating (3/32), symptomatic treatment were relieved; hydrosalpinx Ⅲ- Ⅳ degree of patients, a serious vasovagal reaction (2/15), blood pressure dropped to 50/20 mmHg, after a timely subcutaneous injection of atropine 0.5 mg and active anti-shock treatment, vital signs returned to normal. 236 fallopian tube FTR, isthmic obstruction tubal perforation (2/41). Corner of the palace of the Ministry of Palace obstruction caused by endometrial damage (27/195), contrast agent concentrated in the palace corner into a group, of which 18 cases of uterine vein development. Allergic rash occurred in 4 cases, no abdominal bleeding occurred. 【Conclusions】 In SSG, tubal hydronephrosis is clearly defined, and caution should be taken when further pressurization to prevent severe vagal vagal reaction. FTR low incidence of complications, tubal perforation and uterine horn injury without special treatment, as long as the strict indications, regular operation, gentle action, as a safe inspection and treatment.