【輸卵管通(tong)而(er)(er)不暢】輸卵管通(tong)而(er)(er)不暢怎么辦 輸卵管通(tong)而(er)(er)不暢的原因
輸卵管通而不暢的原因
造成輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)通(tong)而(er)不(bu)暢或(huo)功能(neng)障礙的(de)原(yuan)因(yin)主要(yao)是急、慢性(xing)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)炎(yan)(yan)癥。輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)炎(yan)(yan)，可(ke)分為(wei)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)粘(zhan)膜炎(yan)(yan)和輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)周圍(wei)炎(yan)(yan)，兩者(zhe)(zhe)均為(wei)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)通(tong)而(er)不(bu)暢的(de)常見(jian)病(bing)因(yin)。輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)粘(zhan)膜炎(yan)(yan)嚴重者(zhe)(zhe)可(ke)引(yin)起管(guan)(guan)腔(qiang)(qiang)完全堵(du)塞(sai)(sai)而(er)致(zhi)不(bu)孕(yun)，輕者(zhe)(zhe)盡管(guan)(guan)管(guan)(guan)腔(qiang)(qiang)未(wei)全堵(du)塞(sai)(sai)，但(dan)粘(zhan)膜皺褶發(fa)生粘(zhan)連(lian)使管(guan)(guan)腔(qiang)(qiang)變(bian)窄，或(huo)纖毛缺損影響(xiang)受(shou)精卵(luan)(luan)(luan)(luan)在(zai)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)內正常運行，中途受(shou)阻而(er)在(zai)該(gai)處著床從(cong)而(er)引(yin)起宮(gong)外孕(yun)的(de)發(fa)生。輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)周圍(wei)炎(yan)(yan)病(bing)變(bian)主要(yao)在(zai)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)的(de)漿(jiang)膜層(ceng)，常造成輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)周圍(wei)粘(zhan)連(lian)，輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)扭曲，管(guan)(guan)腔(qiang)(qiang)狹(xia)窄，管(guan)(guan)壁肌蠕(ru)動減弱，影響(xiang)受(shou)精卵(luan)(luan)(luan)(luan)的(de)運行。
淋菌及(ji)(ji)沙眼衣原體所致的(de)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)炎(yan)常累及(ji)(ji)粘膜，而(er)(er)流產(chan)或(huo)(huo)分娩(mian)后(hou)感(gan)染往往引起輸(shu)(shu)卵(luan)(luan)(luan)近端(duan)堵塞或(huo)(huo)通而(er)(er)不(bu)(bu)暢(chang)或(huo)(huo)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)周(zhou)圍炎(yan)。結核性(xing)(xing)(xing)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)炎(yan)病(bing)(bing)變重(zhong)，治愈后(hou)多造成不(bu)(bu)孕(yun)，偶(ou)爾妊娠(shen)，約1/3為輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)妊娠(shen)。結節性(xing)(xing)(xing)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)峽(xia)部炎(yan)是一種(zhong)特(te)殊類型的(de)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)炎(yan)。該病(bing)(bing)變系(xi)由(you)于輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)粘膜上皮呈(cheng)憩室樣向峽(xia)部肌壁內伸展，肌壁發(fa)生結節性(xing)(xing)(xing)增(zeng)生，使(shi)(shi)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)近端(duan)肌層(ceng)肥(fei)厚，影(ying)響其蠕動功能，造成輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)通而(er)(er)不(bu)(bu)暢(chang)。輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)炎(yan)還可(ke)由(you)于輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)周(zhou)圍器官(guan)或(huo)(huo)組織炎(yan)癥(zheng)而(er)(er)繼發(fa)，尤其是在輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)傘部或(huo)(huo)卵(luan)(luan)(luan)巢(chao)周(zhou)圍形成炎(yan)癥(zheng)粘連，使(shi)(shi)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)傘部部分梗阻，甚至不(bu)(bu)能將排出的(de)卵(luan)(luan)(luan)細(xi)胞吸入輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)內與精子(zi)相遇導致不(bu)(bu)孕(yun)。因此，曾患有(you)(you)附件炎(yan)、化膿性(xing)(xing)(xing)闌尾炎(yan)、結核性(xing)(xing)(xing)腹膜炎(yan)、肺結核、子(zi)宮(gong)內膜異(yi)位癥(zheng)的(de)患者，有(you)(you)過不(bu)(bu)全流產(chan)、藥物流產(chan)、人工流產(chan)術后(hou)發(fa)燒、腹痛和產(chan)褥感(gan)染的(de)患者，淋病(bing)(bing)等性(xing)(xing)(xing)病(bing)(bing)患者以(yi)及(ji)(ji)有(you)(you)輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)畸形的(de)患者，均(jun)有(you)(you)可(ke)能導致輸(shu)(shu)卵(luan)(luan)(luan)管(guan)(guan)通而(er)(er)不(bu)(bu)暢(chang)。
輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)通(tong)(tong)(tong)(tong)(tong)液術(shu)又稱輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)通(tong)(tong)(tong)(tong)(tong)水，是(shi)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)通(tong)(tong)(tong)(tong)(tong)暢性(xing)粗(cu)略檢查方(fang)法之(zhi)一(yi)(yi)。可以(yi)大體估計，但不(bu)可以(yi)此為準。有(you)的(de)(de)人(ren)利用輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)通(tong)(tong)(tong)(tong)(tong)水疏(shu)通(tong)(tong)(tong)(tong)(tong)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)，這(zhe)僅僅只(zhi)對輕度(du)的(de)(de)粘連有(you)用，但是(shi)效果不(bu)能肯定。如果粘連是(shi)輕度(du)的(de)(de)話，一(yi)(yi)般在做(zuo)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)造影時就能將它沖開的(de)(de)，造影都(dou)沒(mei)有(you)通(tong)(tong)(tong)(tong)(tong)開的(de)(de)話，用通(tong)(tong)(tong)(tong)(tong)水來疏(shu)通(tong)(tong)(tong)(tong)(tong)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)的(de)(de)可能性(xing)就不(bu)大了(le)。尤其(qi)是(shi)一(yi)(yi)側通(tong)(tong)(tong)(tong)(tong)而(er)另(ling)一(yi)(yi)側不(bu)通(tong)(tong)(tong)(tong)(tong)者，通(tong)(tong)(tong)(tong)(tong)水時，水向壓力(li)(li)低的(de)(de)一(yi)(yi)側流動(dong)(dong)，都(dou)到(dao)通(tong)(tong)(tong)(tong)(tong)的(de)(de)那(nei)一(yi)(yi)側了(le)，對不(bu)通(tong)(tong)(tong)(tong)(tong)的(de)(de)這(zhe)一(yi)(yi)側，影響不(bu)大的(de)(de)。臨床(chuang)上(shang)見過很(hen)多病人(ren)對輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)通(tong)(tong)(tong)(tong)(tong)水不(bu)了(le)解，盲目的(de)(de)通(tong)(tong)(tong)(tong)(tong)水，反(fan)復通(tong)(tong)(tong)(tong)(tong)水對輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)有(you)害無益，一(yi)(yi)是(shi)反(fan)復通(tong)(tong)(tong)(tong)(tong)水有(you)可能影響到(dao)輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)自身的(de)(de)蠕動(dong)(dong)能力(li)(li)和(he)纖毛的(de)(de)擺動(dong)(dong)能力(li)(li)；二是(shi)，每做(zuo)一(yi)(yi)次通(tong)(tong)(tong)(tong)(tong)水就增加(jia)(jia)了(le)一(yi)(yi)次感染(ran)的(de)(de)機會(hui)，尤其(qi)是(shi)消毒不(bu)嚴的(de)(de)情(qing)況下，很(hen)多原(yuan)本輸(shu)(shu)卵(luan)(luan)(luan)(luan)管(guan)(guan)(guan)不(bu)是(shi)很(hen)嚴重的(de)(de)，做(zuo)通(tong)(tong)(tong)(tong)(tong)水后可能進一(yi)(yi)步加(jia)(jia)重。
輸卵管通而不暢怎么辦
如果(guo)(guo)想(xiang)自然受孕的話，必(bi)須先得疏通輸卵管(guan)；如果(guo)(guo)做試(shi)管(guan)，直接做就(jiu)行。
宮腔粘連、輸卵管不通(tong)，雖然有吃(chi)藥、打針(zhen)、輸液、通(tong)水、針(zhen)灸、理療等多(duo)種方法(fa)治療，但(dan)是見效緩慢或(huo)起(qi)效時間(jian)不定甚至(zhi)很(hen)長時間(jian)不見效果，難(nan)以(yi)讓患者滿意(yi)，難(nan)令人(ren)心服口服。
就其病源，從病理(li)學角度(du)分析，宮腔粘連、輸(shu)卵管不通大致分為以下三種情況：
1、粘膜組織粘連；這(zhe)種情況用藥(yao)物如(ru)中藥(yao)的(de)活血化(hua)淤(yu)藥(yao)物等(deng)有可能疏(shu)通(tong)成功，但不(bu)是絕(jue)對的(de)，吃了幾個月(yue)甚至(zhi)一年多藥(yao)物仍未疏(shu)通(tong)的(de)大有人在。
2、結締組織粘連；
3、3、肌層粘連。后(hou)兩種情況，用藥物是不(bu)(bu)可(ke)能解決的(de)(de)，即使多次通(tong)(tong)(tong)水(shui)(shui)也不(bu)(bu)可(ke)能疏通(tong)(tong)(tong)輸(shu)卵管(guan)。光下導(dao)絲介入(ru)術(shu)疏通(tong)(tong)(tong)輸(shu)卵管(guan)，看似容易，其實(shi)(shi)效果并不(bu)(bu)理想：有兩大(da)(da)“先天”“致(zhi)命”缺陷，一為(wei)X光的(de)(de)放射線潛在影響(xiang)；二為(wei)導(dao)絲介入(ru)影響(xiang)輸(shu)卵管(guan)內的(de)(de)纖毛組織(zhi)，影響(xiang)的(de)(de)深(shen)淺幅度及范圍大(da)(da)小不(bu)(bu)易控制，有繼(ji)發宮外孕之虞，況且大(da)(da)量(liang)的(de)(de)臨床(chuang)實(shi)(shi)踐證(zheng)明(ming)，X光下導(dao)絲介入(ru)術(shu)疏通(tong)(tong)(tong)輸(shu)卵管(guan)術(shu)后(hou)患者的(de)(de)受孕率并不(bu)(bu)理想，遠遠低于(yu)正(zheng)常水(shui)(shui)平(ping)腹腔鏡。
