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[Basic Information] Female, 35 years old
[Type of Diseases] Bioplasm tube obstruction
[Treatment Hospital] Qilu Hospital of Shandong University (three)
[Treatment plan] Undercope laparoscopic detection+hysteroscopic detection+liquid -pushing, cephalosporin anti -infection treatment after surgery
[Treatment cycle] 3 days of hospitalization, regular follow -up
[Treatment effect] After treatment, the patient has a good mental state, the wound pain is not obvious, and the recovery is good
The patient is 35 years old and is accompanied by her husband.The patient’s prosecution began to prepare for pregnancy 11 months ago and went to the local hospital reproductive center for examination. No obvious abnormalities were seen, but he had not been pregnant.So six months ago, I went to the reproductive center to give the monitoring ovulation for 3 cycles, injected ovulation -promoting drugs in the 2nd and 3rd cycles.During the period, the patient had no abnormal vaginal bleeding and drainage, no menstrual cycle changes, uncomfortable fever, abdominal pain and other discomfort, no bleeding in the same house, no leucorrhea odor and vulvar itching.Patients went to local hospitals to perform fallopian tubes before April, showing that the bilateral fallopian tubes were completely blocked.Check AMH: 0.52ng/ml, it is recommended to go to the higher-level hospital to do IVF-ET for pregnancy.In order to further treat it, the patient came to our hospital for treatment.
Patients have chronic medical history such as hypertension, diabetes, and no surgical history.After understanding the patient’s condition, I did a gynecological examination for the patient, reminded: the vagina is smooth, the mucosa is smooth, and the vaginal discharge of a large amount of egg whites is not odor.Cervical hypertrophy, III ° erosion, the right side of the front lip is always about 1cm cysts, tin blood (-), the uterus size is normal, good movement, no pain in the uterus, no pain and swing pain, there is no obvious in the double access area area, there is no obvious obvious areatenderness.In order to further treat it, patients earn our department with "bilateral fallopian tube obstruction".
Asked the patient’s medical history, it is good for health and menstrual rules. Since the beginning of the 11 years, the average is 28 days on average, and each time it lasts for 5-7 days.Meridum is medium, no dysmenorrhea, large leucorrhea, yellow yellow, no odor.Three years ago, the patient’s self -prosecution was diagnosed with "chronic pelvic inflammatory inflammatory disease" in the local hospital 3 years ago. It was given a "rehabilitation anti -inflammatory hydrants" treatment after 2 weeks of treatment, and the later review was not scheduled.After the patient was admitted to the hospital, I perfected the relevant examinations. No obvious abnormalities were obviously abnormal.Double limb blood vessel color Doppler ultrasound has not seen obvious abnormalities.Gynecological ultrasound reminder: endometrial echo is owed, and there is a small amount of effusion in the pelvic cavity.
Due to the clear diagnosis and clear surgical indications, after actively excluding surgery taboos, I decided to give patients with laparoscopic detection+hysteroscopy detection+liquid.After communicating with the patient and her family members, she performed a "laparoscopic detection+hysteroscopic detection+liquid" for her next day after admission.The results of laparoscopic detection during the operation were not abnormal, and hysteroscopy, investigating and investigating the biopoppyum tubal intubation of bilateral tubes, and the results showed that the bilateral fallopian tubes were not smooth.The surgery ended smoothly, the anesthesia effect was satisfactory, and the patient’s life signs were stable.After surgery, cephalosporin sodium anti -infection was given, and liquid replenishment was supported.
The patient recovered after surgery, the wound pain was not obvious, the mental state was good, the signs of life were stable, and no adverse reactions occurred. Continue to support the treatment.
1. Develop good living habits, prohibit sexual life during menstruation, change the underwear frequently, pay attention to local cleaning, and avoid pelvic inflammation and attachment inflammation.
2. Patients need to rest in bed to avoid strenuous exercise, stay up late, and develop good living habits.
3. Pay attention to local hygiene. Recently, different rooms have developed good living habits.
4. If you have discomfort, the doctor should be notified in time.
By laparoscopic detection+hysteroscopic detection+liquid -through -liquid, the patient’s mental state is good after surgery, the pain in the self -prosecution wound is not obvious, the mental, diet and sleep during hospitalization are available, and the stool is normal.On the third day after hospitalization, the patient asked for hospitalization. After evaluation, he was discharged.
The patient’s life signs were stable and resumed well at the discharge.
1. Pay attention to rest and reasonable nutrition.
2. Keep the skin around the cutting mouth dry and do not stick water to avoid causing infection.
3. Avoid the basics and sexual life in January, and review the outpatient clinic in January.
4. It should be based on a light diet to avoid spicy and irritating diets. It can be appropriately consumed to eat foods rich in vitamins and protein.
5. Pay attention to the bleeding of the knife mouth and vagina.
For many years, I often encounter young women who cannot conceive normally.There are many reasons for pregnancy difficulties. In addition to the woman’s problems, the man is also important.The most common cause of women is the problem of fallopian tubes, such as fallopian tubes and water accumulation.In addition to the fallopian tube, there are ovaries, such as polycystic ovary syndrome.The main reason for men is sperm problems, such as sperm deformity, poor quality, sperm -free, and less sperm can cause pregnancy difficulties.In this medical record, the radioscope test found that the tubal obstruction was not smooth. Because the sperm and egg binding were in the fallopian tube, the sperm and egg could not be combined, so pregnancy was difficult.
In addition, the location of the fallopian tube obstruction is also very important. If the obstruction site is in the interstitial part, it is impossible to make it unobstructed even if surgery.If the obstruction site is in the position except the section, such as the abdomen or umbrella end of the pot, the general liquid can be used to dredge the liquid through the laparoscopy.Give sperm and eggs to create opportunities to create opportunities, and there will be opportunities for pregnancy.In January after the operation, there was a taboo for a taboo sex life, and closely observed whether there were abnormal vaginal bleeding, and regular outpatient review.Children are the hope of society and the crystallization of every pair of parents. I wish every pair of parents have a healthy and healthy baby!
Name: Zhang Lu
Unit: Qilu Hospital, Shandong University
Department: Obstetrics and Gynecology