自制选择性输卵管再通导管的临床应用研究

Clinical study of home-made selective fallopian tube recanalization catheter

目的 :探讨自制选择性输卵管再通导管的临床应用效果。方法 :5 0 4例经证实有一侧或双侧输卵管不通的不孕症患者 ,采用自制选择性输卵管再通导管进行再通。该导管由导向导管、锥头导管、微导管和导丝 4部分组成 ,导管头端据子宫形态分别弯曲成不同角度的 3种形态。对操作技术也进行了改进。结果 :5 0 4例中经子宫输卵管造影共发现 792支输卵管不通 ,共疏通 73 1支 ,总疏通率 92 .3 %。插管总成功率为 97.4%。发生输卵管穿破 2例 ( 0 .3 9% ) ,宫外孕 6例( 1.19% ) ,均明显低于国外报道。讨论 :采用自制选择性输卵管再通导管并在输卵管疏通过程中 ,应用宫颈牵引法、先冲后通法的操作手法 ,可提高输卵管再通的成功率 。

Objective:To study clinical effect of self made selective fallopian tube recanalization catheter.Methods:504 patients with infertility due to one or both fallopian tube obstruction were treated with self made selective fallopian tube recanalization catheter by means of improved technique. The catheter consists of a guide catheter, a cone head catheter,a micro catheter and a guide wire. The head portion of catheter was bent in conformity to the shape of uterus. Results:In 504 patients, 792 oviducts were confirmed by hystero salpingography to be occluded. Of which 731 were successfully recanalized. The total rate of recanalization was 92.3%. The rate of successful catheterization was 97.4%. Perforation of fallopian tube occured in 2 cases (0.39%).Ectopic pregnancy occured in 6 cases (1.19%) .The complication rate was much lower than that reported by foreign authors.Conclusions:With self made selective oviduct recanalization catheter, the combined use of uterocervical traction and a maneuver of washing first, recanalizing second can improve the success rate of recanalization with less complications .