中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2012年
6期
434-437
,共4页
刘志翔%张艳华%李广宙%张培森%谢海%孙涛%任春娥%张仕状%姜爱芳
劉誌翔%張豔華%李廣宙%張培森%謝海%孫濤%任春娥%張仕狀%薑愛芳
류지상%장염화%리엄주%장배삼%사해%손도%임춘아%장사상%강애방
输卵管疾病%不育,女性%放射性核素显像%锝%中草药
輸卵管疾病%不育,女性%放射性覈素顯像%锝%中草藥
수란관질병%불육,녀성%방사성핵소현상%득%중초약
Fallopian tube diseases%Infertility,female%Radionuclide imaging%Technetium%Chinese herbal
目的 观察核素显像示不同程度输卵管功能损伤患者经内科方法治疗后的妊娠情况,为不同损伤程度输卵管治疗方法的选择提供指导.方法 回顾性分析改良99TcmO-4输卵管显像示至少一侧输卵管通畅的不孕症患者602例,根据输卵管功能损伤情况进行分级(轻度、中度、重度受损,无功能,阻塞),并对不同损伤程度患者采用内科方法(中药腹部热敷+桂芝茯苓胶囊口服+康妇消炎栓直肠给药)治疗后的妊娠情况进行对比分析.采用SPSS 11.0软件对不同组间患者妊娠构成比的比较行x2检验,并计算患者的治愈(输卵管功能恢复正常)率和有效(输卵管功能改善)率.结果 患者经内科方法治疗1～6个疗程,87例(174条输卵管)有治疗前后显像,按条数计,其治愈率为29.5％(46/156),总有效率为71.8％(112/156),治疗前后均正常的输卵管未纳入统计.输卵管不同损伤程度组间妊娠构成比比较,其差异有统计学意义(x2=166.4,P＜0.05).输卵管功能一侧正常而另一侧不同程度受损(A)组,经内科方法治疗后自然妊娠率78.3％ (144/184),较双侧功能均受损者明显增高[一侧轻度受损+另一侧至少轻度受损(B)组、一侧中度受损+另一侧至少中度受损(C)组、一侧重度受损+至少一侧重度受损(D)组相应数据分别为52.6％(102/194)、42.6％(46/108)和13.8％(16/116);x2 =37.86、52.09和121.71,均P＜0.05]；B组和C组经内科方法治疗后自然妊娠率差异无统计学意义(x2=3.29,P≥0.05)；而B组、C组与D组比较,差异均有统计学意义(x2=67.29和42.82,均P＜0.05).D组经内科方法治疗后,自然不孕者占32.8％(38/116),选择行试管婴儿者占53.4％(62/116),其中成功妊娠者占51.6％(32/62).结论 核素显像示输卵管功能轻度受损者内科方法治疗后自然妊娠率较高,而双侧输卵管均重度受损者同样治疗后自然妊娠率低,宜首选行试管婴儿治疗不孕.放射性核素输卵管功能显像对不同损伤程度的输卵管治疗方法的选择具有指导作用.
目的 觀察覈素顯像示不同程度輸卵管功能損傷患者經內科方法治療後的妊娠情況,為不同損傷程度輸卵管治療方法的選擇提供指導.方法 迴顧性分析改良99TcmO-4輸卵管顯像示至少一側輸卵管通暢的不孕癥患者602例,根據輸卵管功能損傷情況進行分級(輕度、中度、重度受損,無功能,阻塞),併對不同損傷程度患者採用內科方法(中藥腹部熱敷+桂芝茯苓膠囊口服+康婦消炎栓直腸給藥)治療後的妊娠情況進行對比分析.採用SPSS 11.0軟件對不同組間患者妊娠構成比的比較行x2檢驗,併計算患者的治愈(輸卵管功能恢複正常)率和有效(輸卵管功能改善)率.結果 患者經內科方法治療1～6箇療程,87例(174條輸卵管)有治療前後顯像,按條數計,其治愈率為29.5％(46/156),總有效率為71.8％(112/156),治療前後均正常的輸卵管未納入統計.輸卵管不同損傷程度組間妊娠構成比比較,其差異有統計學意義(x2=166.4,P＜0.05).輸卵管功能一側正常而另一側不同程度受損(A)組,經內科方法治療後自然妊娠率78.3％ (144/184),較雙側功能均受損者明顯增高[一側輕度受損+另一側至少輕度受損(B)組、一側中度受損+另一側至少中度受損(C)組、一側重度受損+至少一側重度受損(D)組相應數據分彆為52.6％(102/194)、42.6％(46/108)和13.8％(16/116);x2 =37.86、52.09和121.71,均P＜0.05]；B組和C組經內科方法治療後自然妊娠率差異無統計學意義(x2=3.29,P≥0.05)；而B組、C組與D組比較,差異均有統計學意義(x2=67.29和42.82,均P＜0.05).D組經內科方法治療後,自然不孕者佔32.8％(38/116),選擇行試管嬰兒者佔53.4％(62/116),其中成功妊娠者佔51.6％(32/62).結論 覈素顯像示輸卵管功能輕度受損者內科方法治療後自然妊娠率較高,而雙側輸卵管均重度受損者同樣治療後自然妊娠率低,宜首選行試管嬰兒治療不孕.放射性覈素輸卵管功能顯像對不同損傷程度的輸卵管治療方法的選擇具有指導作用.
목적 관찰핵소현상시불동정도수란관공능손상환자경내과방법치료후적임신정황,위불동손상정도수란관치료방법적선택제공지도.방법 회고성분석개량99TcmO-4수란관현상시지소일측수란관통창적불잉증환자602례,근거수란관공능손상정황진행분급(경도、중도、중도수손,무공능,조새),병대불동손상정도환자채용내과방법(중약복부열부+계지복령효낭구복+강부소염전직장급약)치료후적임신정황진행대비분석.채용SPSS 11.0연건대불동조간환자임신구성비적비교행x2검험,병계산환자적치유(수란관공능회복정상)솔화유효(수란관공능개선)솔.결과 환자경내과방법치료1～6개료정,87례(174조수란관)유치료전후현상,안조수계,기치유솔위29.5％(46/156),총유효솔위71.8％(112/156),치료전후균정상적수란관미납입통계.수란관불동손상정도조간임신구성비비교,기차이유통계학의의(x2=166.4,P＜0.05).수란관공능일측정상이령일측불동정도수손(A)조,경내과방법치료후자연임신솔78.3％ (144/184),교쌍측공능균수손자명현증고[일측경도수손+령일측지소경도수손(B)조、일측중도수손+령일측지소중도수손(C)조、일측중도수손+지소일측중도수손(D)조상응수거분별위52.6％(102/194)、42.6％(46/108)화13.8％(16/116);x2 =37.86、52.09화121.71,균P＜0.05]；B조화C조경내과방법치료후자연임신솔차이무통계학의의(x2=3.29,P≥0.05)；이B조、C조여D조비교,차이균유통계학의의(x2=67.29화42.82,균P＜0.05).D조경내과방법치료후,자연불잉자점32.8％(38/116),선택행시관영인자점53.4％(62/116),기중성공임신자점51.6％(32/62).결론 핵소현상시수란관공능경도수손자내과방법치료후자연임신솔교고,이쌍측수란관균중도수손자동양치료후자연임신솔저,의수선행시관영인치료불잉.방사성핵소수란관공능현상대불동손상정도적수란관치료방법적선택구유지도작용.
Objective To observe the conception status of patients with fallopian tube dysfunction after medical treatment and to guide treatment strategy for patients with different degrees of tubal injury by radionuclide imaging.Methods Six hundred and two patients with at least one side of patent fallopian tube underwent modified fallopian tube radionuclide imaging.The patients were graded as:mild,moderate or severe injury,non-functioning or tubal obstruction.The conception status was analyzed after medical treatment,including abdominal hot pack with Chinese medicine,oral intake of Guizhi tuckahoe capsules,and Kangfu anti-inflammatory anal suppository.The constituent ratios of conception in different groups were compared using x2 test and the curative and effective rates were calculated.Results After 1-6 cycles of medical treatment,patients with fallopian tube dysfunction had a curative rate of 29.5％ (46/156) and effective rate of 71.8％ (112/156).There was a statistically significant difference among the different degrees of oviduct injury (x2 =166.4,P ＜ 0.05).After medical treatment,the natural pregnancy rate for patients with bilateral mild,moderate and severe injury was 52.6％ (102/194),42.6％ (46/108) and 13.8％ (16/116),respectively.The rate for patients with one side of normal tubal function was 78.3％ (144/184),which was significantly higher than that of patients with bilateral mild,moderate and severe injury (x2 =37.86,52.09 and 121.71,all P ＜0.05).The natural pregnancy rates of both mild and moderate injury groups were significantly different from the severe injury group (x2 =67.29,42.82,both P ＜ 0.05),but there was no difference between the mild and moderate injury groups (x2 =3.29,P ＞ 0.05).In the severe injury group,32.8％ (38/116) patients were naturally infertile after the medical treatment,while 53.4％ (62/116) patients underwent in vitro fertilization (IVF) and 51.6％ (32/62) of them succeeded in pregnancy.Conclusions The natural pregnancy rate was found to be higher for patients with mild or moderate fallopian tube injuries after medical treatment.In turn,the natural pregnancy rate was found to be lower for those with severely impaired tubal function; therefore,IVF should be recommended.Radionuclide imaging is useful for guiding treatment in different forms of tubal dysfunction.
