B-ultrasonography monitoring tubal fluidization

Ultrasound diagnosis is a new type of science developed since the 1970s. Because of its accurate diagnosis, painlessness, harmlessness and ease of use, it has become an indispensable diagnostic tool for obstetrics and gynecology. On the basis of the traditional principle of tubal patency surgery, the B-mode ultrasound diagnostic apparatus closely monitors the injection of an acoustic contrast agent (1.5% hydrogen peroxide) from the cervix to observe the escape of microbubbles through the fallopian tube to judge its patency. The degree of obstruction greatly improves the accuracy of the diagnosis. Treatment of diseases: infertility, tubal obstruction Indication B-ultrasound monitoring of tubal fluid is applicable to: 1. Various primary or secondary infertility. 2. After infertility surgery, prevent adhesion formation and measure the surgical effect. 3. Unblock the mild adhesion of the fallopian tubes. 4. The therapeutic fluid is started 3 to 4 days after menstruation, 6 times for 1 course of treatment, and 1 course of treatment per month. The drug is 400,000 U of penicillin and 0.5 to 1 g of streptomycin (both allergic tests are required). Hyaluronidase 150 U or acetic acid cortisone 50 mg was dissolved in physiological saline 8-10 ml, and further angiography was performed after 3 courses to determine the therapeutic effect. Contraindications 1. The menstrual cycle disorder has not been corrected. 2. There is a genital tumor in the pelvic cavity. 3. In the acute phase of genital inflammation or chronic recurrent episodes, drug treatment has not been controlled. 4. The general condition is poor, and there are serious diseases such as heart, brain, lung, liver and kidney. 5. It has been clearly identified as a male infertility. Preoperative preparation 1. Time selection 3~7d after menstruation is clean. 3 days before surgery, banned sex life. 2. It is confirmed by various examinations that it is indeed not pregnant. 3. Preoperative examination of leucorrhea routine, blood, urine routine and body temperature, blood pressure. Surgical procedure 1. Empty the bladder, take the bladder lithotomy position, disinfect the vulva and vagina, and sterilize the surgical towel. 2. Double-checking to understand the size, azimuth, texture, activity, shape and relationship with the surrounding organs, and whether there are any abnormalities on both sides of the attachment. 3. The bladder has a lithotomy position and the buttocks are slightly elevated. It is not necessary to empty the bladder to make it fill properly, so as to clearly show the bottom of the palace in the B-ultrasound monitoring. 4. Insert the uterine fluid catheter into the neck tube according to the direction of the probe monitoring, fix it at the preselected depth, and use the tissue clamp to clamp the anterior lip of the cervix to pull the cervix outward, and at the same time push the conical head of the liquid guiding catheter inward. The two are tightly nested. 5. The ultrasound probe is scanned from left to right in the lower abdomen, and the uterine longitudinal image is taken, the uterine diameter line and the uterine cavity direction are measured, and then the transverse shape scan is performed to display the uterus and fallopian tube images. 6. According to the routine operation of the fallopian tube through the liquid, the cervix is injected with physiological saline 30ml (containing gentamicin, chymotrypsin, dexamethasone) to separate the uterine cavity, and see the liquid dark area in the uterine cavity and the fluid flowing through the fallopian tube The situation was followed by injection of an acoustic contrast agent of 1.5% hydrogen peroxide (20 ml) to observe the filling of the gas in the uterine cavity and the escape of microbubbles through the fallopian tubes. After sitting for 5 minutes, check the uterine rectal fossa for fluid accumulation. 7. Unobstructed judgment standard 1 double-sided fallopian tube patency: no normal resistance to saline and hydrogen peroxide, longitudinal observation of uterine cavity separation 0.7cm, visible liquid, micro-bubbles along the fallopian tube, sitting 5min, uterine rectal fossa Fluid. 2 unilateral fallopian tube patency: a little resistance to injection, longitudinal uterine cavity separation 1.0cm, see liquid, microbubbles along one side of the fallopian tube outside, see the uterus rectal effusion after sitting for 5min. 3 bilateral fallopian tube obstruction: high injection resistance, stop injection, liquid reflux. The uterine cavity separation is 1.1cm, and the liquid and microbubbles are flashing in the uterus, and there is no fluid in the uterine rectal fossa.