摘要
目的通过分析228例不同部位阻塞性不孕介入治疗结局,得出该病患介入治疗最佳适应征。方法将228例输卵管阻塞性不孕患者,根据HSG影像分为4组:近端阻塞组(A组)65例;中远端阻塞组(B组)61例;输卵管积水组(C组)52例;输卵管和周围组织粘连组(D组)50例。各组均在philipsTD数字减影X光机下行SSG或FTR术,术后综合性抗炎治疗3个月,随诊1年,观察各组间正常妊娠、输卵管妊娠、再阻塞情况。结果A组正常妊娠33例,61.11%;B组妊娠12例,22.22%;C组妊娠5例,8.33%;D组妊娠2例,4.66%。4组妊娠率存在差异,经χ2分割,A组与B组,A组与C+D组及B与C+D组,均存在差异(χ2=53.46,P<0.001)。输卵管妊娠(TP)发生情况,A组5例,9.25%;B组13例,24.31%;C组14例,29.16%;D组9例,20.93%;4组TP发生率间虽无统计学差异(χ2=6.800,P=0.0785),但经χ2分割,A组与B+C+D组有统计学差异(χ2=5.83,P=0.0158)。1年后再阻塞率A组18.75%;B组61.25%;C组71.05%;D组69.84%;4组再阻塞率间差异有统计学意义(χ2=27.03,P<0.001),经χ2分割,A组与B+C+D组有统计学差异(χ2=25.98,P<0.001)。结论输卵管功能良好,炎症仅局限于输卵管间质、峡部的阻塞性不孕患者,介入复通后其妊娠率最高,输卵管妊娠率、再阻塞率明显低于其他3组;故此,间质、峡部阻塞性不孕为介入手术最佳适应征。
Objective ： To find the best indication by analyzing the effieieney of interventional treatment in 228 eases of infertility eaused by tubal obstruetion in different portion. Methods： The 228 patients were divided into four groups aeeording to the result of HSG. 65 eases in group A were obstrueted in the interstitial and isthmie portion of the tube. 61 eases in group B were obstrueted in the ampulla and end of the tube. 52 eases in group C were aeeumulated with fluid in the tube. 50 eases＇ tubes in group D surrounded by adhesion. All eases got SSG or FFR under Philips TD digital substraetion magiograophy. They were followed up for 1 year after 3 months＇ use of antibiotics. Results： 33 eases （61.1%） in group A, 12 eases （22. 22% ） in group B, 5 eases （8.33%） in group C and 2 eases （4. 66% ） in group D got intrauterine pregnaney. There was signifieant differenee between group A and the other three groups. There was signifieant differenee between group B and group C, D. 5 eases （9. 25% ） in group A resulted in tubal pregnancy （TP）, while 13 eases （24. 31% ） in group B, 14 eases （29. 16% ） in group C and 9 eases （20. 93 % ） in group D got TP. There was signifieant difference of TP rate in four groups, while there was no differenee among group B, C, D. One year after the operation, the tubal reobstruetion rate is 18.75% in group A, 61.25% in group B, 71.05% in group C and 69. 84% in group D. There was signifieant differenee between group A and the other three groups while no differenee among group B, C, D. Conclusion： There was a higher rate of intrauterine pregnancy and lower rate of TP in the eases whose tubes had good funetion and limited inflammation in the interstitial and isthmus portion. Such eases were recommended as the best indication of the interventional treatment.
出处
《中国优生与遗传杂志》
2006年第9期116-118,55,共4页
Chinese Journal of Birth Health & Heredity
关键词
输卵管阻塞
不孕
介入复通
Fallopia table obstruction
Infertility
Interventional reeanalization
