介入性输卵管再通术治疗输卵管阻塞132例临床观察

Clinical observation on 132 cases with tubal obstruction treated with interventional fallopian tube recanalization

目的:探讨介入性输卵管再通术诊治输卵管阻塞的临床效果。方法:采用回顾性分析的方法,对132例不孕症病人使用美国COOK公司生产的输卵管再通器械(包括DBH-100双球囊导管和FTC-550型同轴导管导丝)在X线监测下介入治疗,向导管内注射造影剂观察输卵管通畅情况并术后指导受孕,电话回访3～9个月。结果:132例患者共计264条输卵管梗阻介入术后复通率为81.82%,3个月后妊娠53例,妊娠率为40.15%。导通的输卵管间质部峡部梗阻患者32例,共64条输卵管,输卵管壶腹及伞端梗阻76例共152条输卵管,壶腹部及远端梗阻的患者中有24例导通后造影剂进入盆腔后显示弥散不良,术后受孕最短时间为2个月,最长为7个月,平均5.5个月。结论:介入性输卵管再通术是诊治输卵管阻塞的一种安全有效的方法,为不孕症的临床诊治提供了一种新疗法,可以推广应用。

Objective：To explore the curative effect of interventional fallopian tube recanalization on diagnosis and treatment of tubal obstruction.Methods：Retrospective analysis was conducted in the study,132 infertile patients received fallopian tube recanalization under the monitoring of X-ray,contrast agent was injected into catheter to observe the obstruction of fallopian tube or not,then postoperative conception was directed.Telephone follow up lasted for 3～9 months.Results：The recanalization rate of fallopian tube was 81.82% among 132 patients（264 fallopian tubes）,53 patients got pregnancy after three months,the rate of pregnancy was 40.15%.The types of tubal obstruction included 32 patients with obstruction of isthmus of fallopian tube（64 fallopian tubes）,76 patients with obstruction of ampulla and fimbriae of fallopian tube（152 fallopian tubes）;among the patients with obstruction of ampulla and distal obstruction of fallopian tube,24 patients had poor dispersion after contrast agent into pelvic cavity;the time to pregnancy was 5.5 months on average,from two months to seven months.Conclusion：Interventional fallopian tube recanalization is a safe and effective method in diagnosis and treatment of tubal obstruction,which provide a new therapy for diagnosis and treatment of infertility and is worth popularizing.