腔内留置侧孔导管联合药物灌注预防输卵管复通术后再闭塞的临床研究

Clinical Observation of Indwelling Multiple-side Hole Catheter Combined with Drug Perfusion in Preventing Re-adhesion of Fallopian Tube After Interventional Recanalization

目的探讨输卵管介入再通术（FTR）后输卵管内留置侧孔导管联合药物灌注预防管腔再黏连的临床疗效。方法筛选符合FTR术适应证的输卵管阻塞患者71例,随机分为2组,均常规进行FTR术,试验组术后输卵管内留置导管并持续灌注药物3天,对照组术后输卵管内注入玻璃酸钠并于3天内经宫腔通液每天2次。两组术后第2、6个月均造影复查输卵管通畅情况（闭塞者按各自方法重复治疗1次）。随访患者半年,记录2组患者妊娠情况,观察导管留置是否对输卵管受孕能力造成影响。结果术后第2、6个月试验组输卵管通畅率分别为91.8%（45/49）、89.4%（42/47）,对照组为76.7%（33/43）、72.5%（29/40）,两组相比差异有统计学意义（χ2=4.043,P〈0.05;χ2=4.094,P〈0.05）。术后6个月试验组畅通输卵管受孕率及异位妊娠率分别为21.4%（9/42）、11.1%（1/9）,对照组为20.7%（6/29）、16.7%（1/6）,试验组受孕能力并无下降,其异位妊娠率亦未提高。结论输卵管内留置导管联合药物灌注安全、可靠,能更好地预防FTR术后管腔再黏连,提高远期复通率,不对输卵管的受孕功能造成影响。

Objective To explore the clinical efficacy of indwelling multiple-side hole catheter combined with drug perfusion in preventing re-adhesion of fallopian tube after fallopian tube recanalization（ FTR）. Methods Screened 71 patients with fallopian tube obstruction and prospective FTR indications. The patients were randomized into two groups and treated by FTR,then the experimental group indwelling multiple-side hole catheter combined with drug perfusion in fallopian tube for 3 days,the control group were infused sodium hyaluronate into the tube and with intrauterine cavity perfusion for 3 days. The two groups received followed up examination at 2、6 months after operation（ a treatment was repeated with the case of re-obstruction）. Follow-up for 6 months to evaluate the influence of pregnancy competence of tube with indwelling multiple-side hole catheter. Results The tubal patency rates were 91.8%（ 45/49） 、89.4%（ 42/47） for experimental group at 2、6 months after operation and the control group were 76.7%（ 33/43） 、72.5%（ 29/40）,there was a significant difference between the two groups（ 2 m： χ2= 4.043、P 0. 05; 6 m： χ2= 4.094、P 0. 05）. 6 months after operation,the pregnancy rate and ectopic pregnancy rate of patent tube in experimental group were 21.4%（ 9/42） 、11.1%（ 1/9）,the control group were 20.7%（ 6/29） 、16.7%（ 1/6）,there was no change on the pregnancy competence of fallopian tube after indwelling catheter. Conclusion The indwelling multiple-side hole catheter combined with drug perfusion of fallopian tube can prevent re-adhesion better after FTR,then improve the long-term recanalization rate. There was no change on the pregnancy competence of fallopian tube.