药物黏堵绝育术后近端输卵管闭塞的手术复通效果分析

Modified tubo-uterine implantations for proximal tubal occlusive infertility after femal sterilization with mucflago phenol

目的探讨药物黏堵绝育术后近端输卵管闭塞的手术复通效果。方法对1986年8月至2004年4月间,在中山大学附属第二医院住院的曾接受药物黏堵绝育术,后因各种原因而再行输卵管复通术——输卵管子宫角移植术患者208例的临床资料进行回顾性分析。结果 (1)术中检查输卵管闭塞部位均发生在间质部及峡部。(2)65例盆腔有不同程度粘连,其中57例为轻度疏松粘连,7例为中度粘连,仅1例为重度粘连。(3)输卵管复通术后随访6个月以上者共199例,随访率95.7%。术后第2个月进行输卵管通液检查者共193例,其中185例通畅,通畅率为95.8%(185/193)。(4)获得宫内妊娠143例,宫内妊娠率为71.9%(143/199),其中已足月分娩125例,占87.4%(125/143),足月尚未分娩2例;目前正在早期妊娠3例,中期妊娠2例。(5)自然流产11例,自然流产率为7.7%(11/143)。输卵管壶腹部妊娠2例,占1.0%(2/199)。随访的199例中均未发现有子宫内膜异位的征象。结论药物黏堵绝育术后,近端输卵管闭塞患者行输卵管子宫角移植术的治疗效果肯定,是值得推荐的一种方法。

Objective To explore the effects of modified tube-uterine implantations performed on women with proximal tubal occlusive infertility after femal sterilization with mucilago phenol. Methods Two hundred and eight infertile women who were admitted to the Second Affiliated Hospital of Sun Yat-sen University between 1986 and 2004 were included. They all accepted modified tube-uterine implantation after occlusion of fallopian tubes with mucilago phenol. Results It was found that the occlusions were all located in the interstitial portion or isthmic portion of the fallopian tubes. Different degrees of pelvic adhesions were found in 65 cases. Fifty-seven cases were slightly adhesive, seven cases were of moderate degree and one ease was severe. One hundred and ninety-nine cases were followed up after operations （95.7%）. One hundred and ninety-three women accepted hydrotubation in the following month just after the operation and 185 women were found to be unobstructed （95. 8% ）. One hundred and forty-three women became pregnant, the pregnant rate being 71.9% （ 143/199）. One hundred and twenty-five women had term deliveries （87. 4% ）, three women were in early pregnancy and two in midtrimester pregnancy. Eleven women had spontaneous abortion （7.7%）. Two women had tubal pregnancy（ 1.0% ）. None of the 199 cases had any signs of endometriosis. Conclusions Modified tube-uterine implantations are quite effective for proximal tubal occlusive infertility. It may be a favorable method for such kind of tubal occlusions.