介入治疗输卵管积水所致不孕的临床效果

Clinical effect of interventional treatment for infertility caused by hydrosalpinx

目的:研究介入栓堵术治疗输卵管积水所致不孕的临床应用效果。方法:选择2016年10月至2018年10月大连市妇女儿童医疗中心收治的输卵管积水患者299例,其中169例行介入栓堵患者为研究A组,91例行常规手术治疗(腹腔镜下输卵管造口或者切除治疗)患者为研究B组,39例未治疗患者为对照组。比较三组患者的卵巢功能指标抗缪勒管激素(AMH)、着床率及异位妊娠率。结果:术前,三组AMH差异无统计学意义(P>0.05);术后,研究A组的AMH水平高于研究B组[(3.09±1.73)ng/ml vs.(2.69±2.03)ng/ml],差异有统计学意义(P=0.011),且研究A组术后的AMH水平高于术前[(3.09±1.73)ng/ml vs.(2.30±1.21)ng/ml],差异有统计学意义。研究A组的着床率为42.6%,显著高于研究B组(29.6%)和对照组(10.2%);研究A组的异位妊娠率为1.8%,低于研究B组(3.3%)和对照组(2.6%),差异均有统计学意义(P<0.05)。结论:对输卵管积水实施介入栓堵治疗,卵巢功能不受影响,着床率较高,异位妊娠率较低,操作技术可靠,值得临床推广应用。

Objective:To study the clinical application effect of interventional embolization for the treatment of infertility caused by hydrosalpinx.Methods:A total of 299 patients with hydrosalpinx admitted to the Dalian Women and Children Medical Center from October 2016 to October 2018 were enrolled.Among them,169 patients underwent interventional embolization for study group A and 91 patients underwent routine surgery(laparoscopic surgery).Patients with tubal stoma or resection were studied in group B,and 39 untreated patients were in the control group.The ovarian function of anti-Mullerian hormone(AMH),implantation rate and ectopic pregnancy rate were compared between the three groups.Results:There was no significant difference in AMH between the three groups before operation(P>0.05).After operation,the AMH level in group A was higher than that in group B[(3.09±1.73)ng/ml vs.(2.69±2.03)ng/ml],the difference was statistically significant(P=0.011),and the AMH level in the study group A was higher than that before surgery[(3.09±1.73)ng/ml vs.(2.30±1.21)ng/ml],the difference was statistically significant.The implantation rate of the study group A was 42.6%,which was significantly higher than that of the study group B(29.6%)and the control group(10.2%).The ectopic pregnancy rate of the study group A was 1.8%,which was lower than that of the study group B(3.3%).There was a statistically significant difference between the control group and the control group(2.6%)(P<0.05).Conclusions:Interventional embolization for the treatment of hydrosalpinx,ovarian function is not affected,the implantation rate is higher,the ectopic pregnancy rate is lower,the operation technology is reliable,and it is worthy of clinical application.