显微输卵管吻合术116例临床分析

Clinical analysis of microscopic anastomosis of fallopian-tubes in 116 cases

目的探讨显微输卵管吻合术影响妊娠率的相关因素。方法内江市妇幼保健院2007～2010年共实施显微输卵管吻合术138例,对其中116例完成了随访。术中采用显微输卵管吻合,放大4～6倍,0/8显微线缝合肌层、浆膜层各4针,术中近端阻塞用cook导丝疏通,吻合成功后将防粘剂——欣可聆注入管腔,术后无需通液。结果输卵管复通率100.00%,双侧输卵管通畅率95.69%,妊娠率90.52%。术后妊娠率与结扎部位无显著关系(P>0.05),复通时年龄与术后妊娠率有显著关系(P<0.05),术后输卵管长度<6cm时妊娠率仅20.00%。结论结扎部位对妊娠无明显影响,术中使用防粘剂,术后无需通液。年龄≥40岁或输卵管长度<6cm,妊娠率明显下降。

Objective To study relative effect factors of microscopic anastomosis on pregnancy rate. Methods During Jan. of 2005 -y to Dec. 4 of 2008 -y, totally 138 cases were successfully performed the microscopic anastomosis of fallopian -tubes, among which 116 cases were followed up completely after operation. Their operations were all done by microscopic anastomosis, through a 4 ~ 6 fold amplifications, 4 - stitche technique suturing the muscle layers adopting 0/8 micro -line, 4 stitches on serosa, and re -dredging the proximal block of Fallopean tubes near - end congestions and blocks via cook guide - wire. Singclean anti - adhesive agent was injected into tubal lumia after operation while saving all other dredge - liquids. Results The recanalization rate of fallopian tube was 100.00% , the patency rate of bilateral tube was 95.69% and the pregnancy rate was 90. 52%. The discrepancies between their ligation spots and the gestation rate after operation had no statistics significance （ P 〉 0. 05 ） ; while the differences between age of women at recanarilization and post - operation gestation rate were found significance（ P 〈 0.05 ）. When the fallopian tube length was 〈 6 cm after operation, its gestation rate remained low at only 20. 00%. Conclusion The ligation spots has no effect on the pregnancy rate. Singclean anti - adhesive agent used after the operation may save all other dredge -liquids. These pregnancy rates after operation are apparently declining in these women with ≥40 years old or their tube length is 〈 6 cm.