输卵管造影和插管术在输卵管手术中的应用

The Usage of Salpingography and Fallopian Catheterization in Tube Operation

目的：在妇科输卵管手术中采用非血管介入手术-输卵管造影和输卵管插管术放入支架，以提高术后输卵管的通畅率及术后妊娠率。方法：回顾性分析61例输卵管整形手术患者，31例观察组术中应用输卵管造影和插管技术，在输卵管狭窄处或端端吻合处放置微导管作为支架，头端置于腹腔或输卵管腔，尾端置于宫腔内，术后1～2月后月经来潮时取出；30例对照组自输卵管伞端至宫角放置支架，尾端固定于腹壁切口，术后3—4天取出。观察、随访两组术后输卵管通畅率和妊娠率。结果：观察组31例共59条输卵管中，术后3个月53条输卵管通畅，占89．83％，2年内19例妊娠，占61．29％；对照组30例共58条输卵管，术后3个月27条通畅，占46．6％，2年内9例妊娠，占30％。两组对比，观察组术后输卵管通畅数、两年妊娠数明显高于对照组（P〈0．001、P〈0．01）。结论：在输卵管整形手术中应用输卵管造影和输卵管插管，置入输卵管支架至创面愈合后取出，明显提高了术后输卵管的通畅率及再妊娠率，为输卵管再通提供了一种新的有效的治疗方法。

Objective：To explore the clinical value of salpingography and fallopian catheterize in recanalization of fallopian tubes and promotion of pregnancy. Methods：61 cases were retrospectively analyzed. In observation group, micro - catheters were put in the fallopian cavity of the terminoterminal anastomosis position as stent in 31 patients, using salpingography and fallopian catheterization. In control group, the catheter was put from the fimbriae to the comual of the uterine in 30 cases. The recanalization and the pregnancy rate were observed. Results： After 3 month, recanalization rate was 89.83% and 46.6% in observation group and control group respectively（ P〈 0. 001 ）. In 2 years, 19 pregnancies occurred in observation group, while only 9 in control group, pregnancy rate was 61.29% and 30% respectively（ P〈 0. 01）.Conclusions： Salpingography and fallopian catheterize in fallopian reforming operation significantly increase the recanalization and pregnancy rate, providing a new and useful method.