介入再通联合臭氧治疗阻塞性输卵管炎的实验研究

Interventional fallopian tube recanalization combined with ozone injection in treating chronic obstructive salpingitis: an experimental study in rabbits

目的观察介入再通联合医用臭氧治疗慢性阻塞性输卵管炎的疗效,为临床应用提供实验依据。方法采用经子宫输卵管插管介入途径建立炎性阻塞动物模型。将新西兰大白兔分为30μg/ml臭氧治疗组(A组)、40μg/ml臭氧治疗组(B组)、常规介入治疗组(C组)及模型对照组(D组),每组10只,同时取正常兔10只作为空白对照组(E组)。在常规介入治疗后,A组和B组再经导管分别注入30μg/ml及40μg/ml臭氧各10 ml;D组和E组给予等量生理盐水。术后4周观察各组兔输卵管病理形态学改变。结果 A、B、C、D组介入术中输卵管再通技术成功率分别为88.9%、85.0%、88.9%和81.3%。与D组比较,A、B、C组输卵管炎症改善显著,组间差异有统计学意义(P<0.05),A、B组与C组比较,疗效差异亦有统计学意义(P<0.05),但A组与B组间疗效差异无统计学意义(P>0.05)。结论 30和40μg/ml臭氧均可不同程度改善输卵管慢性阻塞性炎症,值得在临床进一步推广使用。

Objective To assess the therapeutic value of interventional fallopian tube recanalization （FTR） combined with ozone injection in treating chronic obstructive salpingitis in experimental rabbits in order to provide references for clinical application. Methods The animal model of chronic obstructive salpingitis was established through interventional uterotubal catheterization in New Zealand white rabbits. A total of 40 rabbit models with salpingitis were randomly and equally divided into four groups： group A （30 μg/ml ozone）, group B （40 μg/ml ozone）, group C （conventional interventional treatment） and group D （modeling control group）. Another ten healthy rabbits were used as a blank control group （group E）. After interventional FIR was successfully finished, 10 ml of 30 μg/ml ozone and 40 μg/ml ozone was injected through the catheter into each fallopian tube in the rabbits of group A and group B respectively, while anti-inflammatory drug was given to the rabbits in group C, and 10 ml of saline was injected in the rabbits of both group D and group E. Four weeks after the treatment, the experimental rabbits were sacrificed, and the fallopian tubes were collected and sent for macroscopic and microscopic examination. Results The recanalization rate of the fallopian tube in group A, B, C and D was 88.9%, 85.0%, 88.9% and 81.3%, respectively. The severity of salpingitis observed in group A, B and C was significantly improved when compared to that observed in group D （P 〈 0.05）. Statistically significant difference in the therapeutic effect existed between group A and C, as well as between group B and C （P 〈 0.05）, although the difference between group A and group B was not statistically significant （P 〉 0.05）. Conclusion Additional use of ozone injection with the concentration of 30 μg/ml or 40 μg/ ml following interventional fallopian tube recanalization management can surely improve the chronic obstructive salpingitis to a certain degree in experimental rabbits. This technique might be advocated in clinical practice.