输卵管介入再通单人操作套件与双人操作套件的对比研究

Comparative study on single and double kit for FTR

目的:探究输卵管介入再通(FTR)手术单人操作的可行性,提出单人操作套件的改进方案。方法:选取经子宫输卵管造影(HSG)诊断的65例输卵管近端梗阻患者,根据FTR术中操作方法不同,将采用双人套件操作的患者纳入双人套件组(33例),采用单人套件操作的患者纳入单人套件组(32例),比较两组患者FTR术中子宫形态及位置、钳夹宫颈与否、再通术成功率、透视时间、辐射剂量及患者视觉疼痛量表(VAS)得分情况。结果:两组FTR术中再通成功率及相关手术指标比较,差异均无统计学意义(t=1.34,t=1.12,t=0.89,t=0.56;P>0.05);三角形宫腔患者手术透视时间长、术后VAS得分高,与倒三角形及梭形宫腔比,三角形宫腔患者差异有统计学意义(F=6.34,F=5.22;P<0.05)。结论:FTR术中单人操作套件可较好地替代双人操作套件功能,对于操作难度高的患者,单人操作套件仍需改进;在三角形宫腔操作困难时应尽早采用双人操作。

Objective: To explore the feasibility of one man operation for fallopian tube recanalization(FTR) and put forward improvement plan for the kit of one man operation. Methods: 65 patients with proximal fallopian tube obstruction who were confirmed by hystero-salpingography(HSG) were selected. According to the different method in the FRT operation, 33 patients who underwent double kits were divided into double kits group, and 32 patients who underwent single kit were divided into single kit group. The series of indicators included uterine morphology and position, whether to clamp the cervix, success rate of recanalization, fluoroscopy time, radiation dose and visual analogue scale(VAS) scores of two groups were compared. Results: There was no statistical differences in success rate of recanalization and related surgical indicators between the single kit group and double kits groups(t=1.34, t=1.12, t=0.89, t=0.56, P>0.05). The fluoroscopy time of patients with triangular uterine cavity was significantly longer than that of patients with inverted triangular uterine cavity, and the VAS score of patients with triangular uterine cavity was significantly higher than that of patients with inverted triangular uterine cavity(F=6.34, F=5.22,P<0.05). Conclusion: In FTR surgery, single kit can better substitute the function of double kits. For patients with higher difficulty of operation, the single kit should to be improved. When the difficulties occurred in operation of triangular uterine cavity, the double men operation should be adopted as soon as possible.