不同干预方法对输卵管通而不畅者186例的疗效分析

The effectiveness of different interventional methods for partial fallopian tube obstruction:an analysis of 186 cases

目的探讨不同干预方法对输卵管通而不畅者的疗效。方法选择2008年1月-2010年10月经子宫输卵管造影证实为输卵管通而不畅186例患者。根据患者同意选择的治疗方法的不同分为A、B两组,A组(非介入治疗组)78例,干预方法包括通水、灌肠、中药、理疗、腹腔镜等;B组(选择性输卵管插管疏通治疗组)108例。观察两组患者治疗后6个月内受孕率及6个月后复查输卵管堵塞情况。逐一记录追踪结果,并进行统计学处理,计数资料采用卡方检验。结果 6个月后A组受孕10例,受孕率12.82%,未孕者6个月复查造影28例48条输卵管不同程度堵塞,堵塞率31.58%;B组6个月后受孕63例,受孕率58.33%,未孕者6个月后复查造影1例1条输卵管间质部堵塞,堵塞率0.47%。两组比较,受孕率及堵塞率差异有统计学意义(P<0.05)。结论治疗输卵管通而不畅,B组治疗效果明显优于A组,B组干预方法,值得临床推广。输卵管通而不畅者需积极干预,合理治疗。

Objective To evaluate selective salpingo-catheterization recanalization therapy in treating partial fallopian tube obstruction through comparing its clinical effectiveness with that of non-interventional radiology methods.Methods During the period from January 2008 to October 2010,a total of 186 infertility women with partial fallopian tube obstruction,which was confirmed with hysterosalpingography,were encountered in authors＇ hospital.This study protocol was approved by our hospital ethics committee,and informed consent was obtained from all patients.According to different treatment methods,186 patients were divided into two groups.Patients（n = 78） in group A received non-interventional radiology methods,including hydrotubation,enema,laparoscopy,physical therapy and traditional Chinese medication,while patients（n = 108） in group B received selective salpingo-catheterization recanalization therapy.All 186 patients were followed up for more than six months.Close observation on the pregnancy incidence after different treatments and fallopian tube patency was carried out.The clinical findings were documented.The results were statistically analyzed by using paired ＂x2＂ test.Results Half a year after different procedures,in group A the pregnancy rate was 12.82%（n = 10）,and different degrees of fallopian tube obstruction were found in 31.58% patients.Whereas in group B,during the same period of observation,the pregnancy rate was 58.33%（n = 63）,and partial occlusion in cornual region was seen in one patient（0.47%）.Significant difference in both pregnancy rate and fallopian tube occlusion rate existed between two groups（P 0.05）.Conclusion Because of its minimal invasiveness,high effectiveness and safety,the selective salpingography together with fallopian tube recanalization procedures are well accepted by the patients.The selective salpingo-catheterization recanalization therapy is superior to non-interventional radiology methods in increasing the pregnancy rate and reducing the fallopian tube occlusion rate.It is of value to popularize this technique in clinical practice.