hysterography

Hysterosalinography (HSG) has been used in the 1920s to inject a high-density substance iodine composed of high atomic number into the uterine cavity through the cervical canal, which is evident in the X-ray film and surrounding tissues. The artificial contrast is used to visualize the lumen to understand the condition of the uterus and the fallopian tube. The angiography can not only indicate whether the fallopian tube is patency, the location of the obstruction, but also the morphology of the uterine cavity. This type of examination is safe, does not require anesthesia, has no obvious pain, and is acceptable to the patient. Treatment of diseases: uterine dysplasia of endometrial polyps Indication 1. Examination of cervical sag, such as habitual abortion, cervical sinus relaxation, cervical fistula, etc. 2. Examination of cervical stenosis: Congenital neck stenosis, stenosis caused by chronic diseases such as tuberculosis, inflammation, sexually transmitted diseases, atrophy and stenosis in old age, and stenosis due to artificial abortion. 3. Whether the uterus is developed with or without deformity, uterine position, wall tension, and adhesion of the uterine cavity. 4. Inflammatory lesions, chronic endometritis, tuberculosis, etc. 5. Intrauterine foreign body and space-occupying lesions, such as hydatidiform mole, new organisms: polyps, fibroids and cancer, extrauterine compression lesions. 6. The fallopian tube is unobstructed or blocked, present or absent. 7. Fallopian tube shape, width, length, curvature and direction. 8. Oviduct diseases such as inflammation, effusion, tuberculosis, and distortion caused by peripheral adhesions. 9. Diagnosis of ectopic pregnancy and abdominal pregnancy. 10. Check the relationship between the reproductive organs and adjacent organs, abdominal wall sinus and abnormal fistula to determine the scope and method of surgery. 11. After the iodine overflows from the fallopian tube, it is distributed in the pelvic cavity to determine the extent of pelvic lesions. 12. After the fallopian tube occlusion, check whether the operation is successful, the position of the occlusion, and whether the pelvic cavity is infiltrated. Contraindications 1. Patients with serious organs in the whole body have serious diseases, including circulation, respiration, urinary and blood system. 2. Body temperature exceeds 37.5 °C. 3. Allergic to iodine. 4. Genital infection, acute and subacute inflammation of the pelvic cavity. 5. Amenorrhea can not exclude pregnant women. 6. Irregular uterine bleeding. 7. Pregnancy, puerperium, menstrual period. 8. Intrauterine malignant tumors prevent the metastasis of cancer cells to the oviduct and abdominal cavity. 9. After curettage and uterine surgery (such as uterine fibroids removal, malformation of uterus correction, uterine rupture repair, laparoscopic direct surgery, etc.), the endometrium has not fully recovered before. Preoperative preparation 1. Detailed medical history, routine leucorrhea examination, blood tests for liver function, hepatitis B surface antigen, erythrocyte sedimentation rate, electrocardiogram, body temperature and blood pressure, cervical smear for cancer cells. 2. The angiographic date is selected on the 3rd to 7th day after the menstruation is clean, during which life is prohibited. 3. Preoperative iodine allergy test 1 Potassium iodide: 1 tablet orally, 3 times a day for 3 days, pay attention to whether there is any reaction during the medication. 2 Iodine oil scratch test: After half an hour, pay attention to the systemic allergic reaction and local skin erythema. 330% of diatrizoate, 1 ml, intravenous bolus, observed for reaction within half an hour. 4. Take the laxative on the eve of the angiography to relieve the stool, or check the enema 1 h before. 5. Empty the urine before surgery. Surgical procedure 1. The patient is lying on the fluoroscopy table and the bladder is in the stone. Rinse the vulva and vagina, expose the vagina and cervix with a vaginal device, and disinfect the cervix with a 10% thimerosal cotton ball. 2. Prepare dark adaptation, perform pelvic double examination, determine the position of the uterus, check whether the contrast instrument is smooth, whether there is leakage at the joint, whether the contrast agent has deteriorated and expired, pumping and injecting contrast agent, filling the catheter, will be loaded A syringe with a contrast agent is connected to the catheter. 3. Clamp the anterior lip of the cervix with a cervical forceps, fix the contrast cone with a conical rubber head 1.5 cm away from the end of the catheter, place the catheter into the neck tube, tighten tightly, slowly inject iodine preparation under fluoroscopy, and inject 6 ml of uterus and The fallopian tubes are all filled, and the amount of the uterine cavity is larger. 4. Generally stop the injection after the uterine fallopian tube is filled and take the first piece. After the second film was taken for 5.24 hours, the residual iodine preparation in the vagina must be scrubbed before the filming.

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