透明质酸钠在微创治疗输卵管阻塞性不孕中的应用观察

Study on the application value of sodium hyaluronate in the minimally invasive treatment of tubal obstruction infertility

目的：比较透明质酸钠凝胶与松解液在宫腹腔镜联合COOK导丝治疗输卵管阻塞性不孕患者的临床疗效。方法选择2011年10月～2013年10月输卵管阻塞不孕患者55例，分成治疗组28例和对照组27例。治疗组使用医用透明质酸钠凝胶30mL，对照组使用松解液30mL。比较两组术后宫内妊娠率、异位妊娠率及卵管通畅率。结果术后3个月两组阻塞情况比较，治疗组阻塞率为0，对照组为3.7%，差异有统计学意义（P＜0.05）。术后1年内两组患者妊娠情况比较，治疗组宫内妊娠率60.7%、异位妊娠率7.1%，对照组宫内妊娠率33.3%、异位妊娠率29.6%，差异有统计学意义（P＜0.05）；两组患者输卵管通畅情况比较，治疗组通畅率75.0%、通而不畅率14.3%，对照组通畅率44.4%、通而不畅率40.7%，差异有统计学意义（P＜0.05）。结论在宫腹腔镜联合COOK导丝治疗的基础上使用透明质酸钠凝胶能够有效减少手术损伤，预防术后粘连，提高患者宫内妊娠率，降低异位妊娠率。

Objective To compare the clinical efficacy of hyaluronic sodium gel and release liquid in patients treated for fallopian infertility by Laparoscopy combined clinical efficacy COOK guide wire plug.MethodsWe selected 55 cases of patients who were treated for tubal obstruction infertility in our hospital from October 2011 to October 2013,they were randomly divided into two groups ,the treatment group and control group, the treatment group has 28 cases ,and the control group has 27 cases . The treatment group used 30ml of sodium hyaluronate gel, and the control group used 30ml of release liquid. We compared the rate of postoperative intrauterine pregnancy, the rate of ectopic pregnancy and tubal patency. ResultsThe obstruction status of the two groups after three months was as follow, the blocking rate of the treatment group was zero. While 3.7% in the control group, there was a significant difference （P〈0.05）. The pregnancy rate of 1 year postoperative ,the rate of intrauterine pregnancy was 60.7% in the treatment group ,the rate of ectopic pregnancy was 7.1% , while the rate of intrauterine pregnancy was 33.3% in the control group , the rate of ectopic pregnancy 29.6% , there was a significant difference （P〈0.05 ） ; the patency rate of the treatment group was 75.0% , the poor patency rate of 14.3%, while the rate was 44.4% and 40.7% in the control group respectively, there was a significant difference （P〈0.05 ） . Conclusion Using of sodium hyaluronate gel based on laparoscopic treatment of joint COOK guide wire Palace can effectively reduce the surgical trauma, prevention the postoperative adhesions, improve the rate of intrauterine pregnancy, and reduced the rate of ectopic pregnancy.