摘要
目的探讨输卵管再通术后使用外科手术用防粘连冲洗液,防止复发性粘连的疗效及价值。方法选择2005年4月至2008年4月在本院妇产科因不孕症住院治疗,术前输卵管碘油造影证实为输卵管中、远端堵塞的208例患者为研究对象。随机将其分实验组(n=105)和对照组(n=103)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。两组患者平均年龄、输卵管堵塞情况、不孕类型及相应不孕时间等比较,差异无显著意义(P>0.05)。实验组于输卵管堵塞再通术后,经输卵管及盆腔注入外科手术用防粘连冲洗液(羧甲基壳聚糖及平衡液)20mL,对照组于输卵管堵塞再通术后,经输卵管及盆腔注入a-糜蛋白酶、庆大霉素、地塞米松防止粘连。随访观察1～2个月后,进行通液通畅率、术后受孕率[尿人绒毛膜促性腺激素(human chorionic gonadotrophin,hCG)阳性率及超声定位]。结果实验组术后输卵管再通畅率为95.8%(162/169),术后随访1～2个月后复查,通畅率为95.1%(98/103),累计受孕率为40.1%(41/102);对照组术后输卵管再通率为96.3%(160/166),术后1～2个月后复查,通畅率为86.2%(88/102),累计受孕率为35.3%(35/99)。输卵管堵塞再通术后,实验组和对照组通液通畅率及术后累计受孕率比较,差异有显著意义(P<0.05)。结论输卵管堵塞再通术后,使用外科手术用防粘连冲洗液,可效降低术后再粘连输卵管堵塞的复发率,提高受孕率。
Objective To investigate the impact of using surgical anti adhesion fluid to flush fallopian tube after blocked fallopian tubal recanalization surgery on post-operative tubal patency and pregnancy rate. Methods From April 2005 to April 2008, 208 cases were diagnosed as infertility were recruited in the Department of Obstetrics and Gynecology, Second People＇s Hospital of Ya＇an City. They were divided into treatment group （n=105） and control group （n=103）. Informed consent was obtained from all patients. There were no significant differences in mean age, situation of fallopian tube jam, infertility type and duration of infertility between two groups （P〈 0. 05）. Both two groups underwent fallopian tube recanalization for block tubes. In treatment group, after the procedure, surgical anti adhesion flushing fluid （carboxymethyl chitosan and balanced salt solution, 20 mL） was injected into the fallopian tubes and pelvic, while control group received a chymotrypsin, gentamicin and dexamethasone to prevent postoperative adhesions. Follow-up observation of 1-2 months of patency rate and postoperative pregnancy rate f-positive rate of human chorionic gonadotrophin（hCG） and ultrasound positioning]. Results In treatment group, the blocked fallopian tubal re-patency rate immediately after surgery was 95. 8% （162/169）, and in control group was 96.3%（160/166）. The blocked fallopian tubal re patency rate immediately after surgery had no significant difference of two groups（P〉0.05）. In 1 2 months after surgery, the tube patency rate and an overall pregnancy rate between treatment group and control group was 95. 1% （98/103） vs. 86. 2% （88/ 102）, and 40. 1% （41/102） vs. 35. 3% （35/99）. They had significant difference in patency rate and postoperative pregnancy rate between two groups （P〈0. 05）. Conclusion After blocked fallopian tube recanalization, surgical anti adhesion fluid to flush may be effective to reduce the recurrence rate of postoperative adhesions block and improve pregnancy rate.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2010年第2期100-103,共4页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
关键词
输卵管堵塞再通术
防粘连冲洗液
复发性粘连
blocked fallopian tubal recanalization surgery
anti adhesion flushing fluid
recurrent adhesions
