输卵管阻塞性不孕症介入再通术后通畅率影响因素的Logistic回归分析

Logistic regression analysis on patency rate of Fallopian tubes after recanalization in patients with infertility due to tubal obstruction

目的研究输卵管阻塞性不孕症介入再通术后输卵管通畅率的影响因素。方法选择行输卵管阻塞性不孕症介入再通术患者100例,随机平均分为对照组和治疗组。术前调查年龄、病程、流产史、异位妊娠史等。两组手术方法相同,对照组疏通液包括地塞米松、庆大霉素、α-糜蛋白酶、生理盐水;治疗组增加复方丹参注射液。术后6个月复查输卵管选择性造影,比较术后通畅率与各因素的相关性。结果复查发现不同年龄、不同病程、有无流产史、有无异位妊娠史患者间通畅率无统计学差异(P>0.05)。治疗组通畅率显著高于对照组(P<0.05),无盆腔操作史者通畅率显著高于有盆腔操作史(P<0.05),原发性不孕症患者通畅率显著低于继发性不孕症患者(P<0.05),输卵管间质及峡部阻塞者通畅率最高(100.00%)、壶腹部次之(97.50%)、伞部最低(65.22%);治疗方法 (OR=3.823)、不孕症类型(OR=3.234)、阻塞部位(OR=3.527),盆腔操作史(OR=0.179)均与通畅率相关(P<0.05)。结论输卵管阻塞性不孕症介入再通术后通畅率与是否联合应用丹参注射液、有无盆腔操作史、原发性/继发性不孕、输卵管阻塞部位等因素相关;与年龄、病程、流产史、异位妊娠史无明显相关性。

Objective To study the influencing factors of patency rate of Fallopian tubes after recanalization in patients with infertility due to tubal obstruction.Methods A total of 100 patients with infertility due to tubal obstruction who were treated with Fallopian tube recanalization were randomly and equally divided into control group and treatment group.Age,the course of disease,history of abortion and ectopic pregnancy were investigated before operation.The surgical methods in the two groups were the same,the drugs used in control group included dexamethasone,gentamicin,α-chymotrypsin and normal saline,and the drugs used in treatment group included compound Danshen injection combined with dexamethasone,gentamicin,α-chymotrypsin and normal saline.Selective salpingography was used for reexamination after six months,the correlations between the patency rate and all the factors were compared.Results There was no statistically significant difference in the patency rate among the patients in different age groups,with different courses of disease,having abortion history or not,having ectopic pregnancy history or not（ P〈0.05）.The patency rate in treatment group was statistically significantly higher than that in control group（ P〉0.05）.The patency rate in the patients without pelvic operation history was statistically significantly higher than that in the patients with pelvic operation history（ P〈0.05）.The patency rate in primary infertility patients was statistically significantly lower than that in secondary infertility patients（ P〈0.05）.The patency rate of interstitial and isthmus Fallopian tube obstruction was the highest,followed by ampulla Fallopian tube,and the patency rate of umbrella Fallopian tube obstruction was the lowest.Treatment（ OR = 3.823）,types of infertility（ OR = 3.234）,obstruction sites（ OR = 3.527） and pelvic operation history（ OR = 0.179） were correlated with patency rate.Conclusion The patency rate of Fallopian tubes after recanalization in patients with infertility due to tubal obstruction is related to application of Danshen injection,pelvic operation history,primary/secondary infertility and obstruction sites,which is not correlated with age,course of disease,abortion history and ectopic pregnancy history.