输卵管宫腔植入术的动物实验研究

Tubouterine Implantation in Rabbits

目的:探讨家兔输卵管宫腔植入术的可行性以及提高术后通畅率的方法。方法:以34只新西兰兔为研究对象,在显微器械辅助下分别对其行双侧输卵管宫腔植入术,术中使用硬脊膜外麻醉导管作为支架。以术中输卵管植入子宫壁的深度和术后是否留置支架为依据分成4组:无支架浅植入组(S组),无支架深植入组(D组),留置支架浅植入组(SS组)和留置支架深植入组(DS组)。术后7d取支架,28d剖腹探查,子宫输卵管通美蓝液了解输卵管通畅情况。结果:4组共有66条输卵管植入子宫,S组、D组、SS组、DS组的通畅率分别为5.9%、37.5%、68.6%、88.2%。深植入者(D组+DS组)输卵管术后通畅率(63.6%)高于浅植入者(S组+SS组)(36.4%),留置支架者(SS组+DS组)(78.8%)高于未留支架者(S组+D组)(21.2%)。结论:术中引导输卵管完全进入宫腔及术后输卵管内留置支架可提高术后输卵管通畅率。

Objective： To explore the feasibility of tubouterine implantation in rabbits and to compare the effect of different surgical methods. Methods： Thirty-four New Zealand rabbits were studied. Tubouterine implantation was conducted in bilateral fallopian tubes and uteri of each rabbit. Peridural anesthesia catheter was used to support the fallopian tube intra-operatively. Four groups were formed based on the depth of implantation and whether the catheter was retained as a stent for 7 d. Namely： shallow implantation without stent （S group）, deep implantation without stent （D group）, shallow implantation with stent （SS group） and deep implantation with stent （DS group）. Exploratory laparotomy was performed 28 d later. The tubal patency was evaluated by the introduction of methylene blue. Results： A total of 66 tubes were implanted into the uteri with patent rates of 5.9% （S group）, 37.5% （D group）, 68.6% （SS group） and 88.2% （DS group）, respectively. Thirty-three tubes received deep implantation （D＋DS groups） with a 63.6% patent rate which was statistically higher than that of the tubes receiving shallow implan- tation （36.4%, S＋SS groups）. Similarly, tubes with stents generated a higher patent rate （78.8%, SS＋DS groups） comparing with those without postoperative stems （21.2%, S＋D groups）. Conclusion： To guide the tube through the uterus into the cavity and keep a stent for postoperative supporting are both conducive to a higher tubal patency.