宫-腹腔镜手术联合宫安康、几丁糖治疗对输卵管阻塞性不孕症患者术后输卵管通畅率和临床妊娠的影响

FEffects of hysteroscopy-laparoscopy combined with Gong ankang and chitosan the rapy on postoperative tubal patency rate and clinical pregnancy in patients with tubal obstructive infertility

目的 探究宫-腹腔镜手术联合宫安康、几丁糖治疗对输卵管阻塞性不孕症患者术后输卵管通畅率和临床妊娠的影响。方法 采用随机数字表法将2020年2月至2022年2月于长沙市妇幼保健院治疗的94例输卵管阻塞性不孕症患者分为对照组和观察组,各47例。对照组给予宫-腹腔镜手术治疗,观察组给予宫-腹腔镜手术联合宫安康、几丁糖治疗。比较两组术后1年内输卵管通畅情况、临床妊娠率及手术前后卵巢功能指标、炎性因子水平,并统计患者术后并发症发生率。结果 观察组输卵管通畅程度优于对照组,输卵管完全通畅率高于对照组(P<0.05)。两组术后3个月的子宫内膜厚度均大于术前(P<0.05)。观察组术后3个月的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及γ-干扰素(IFN-γ)水平均低于对照组(P<0.05)。观察组宫内妊娠率及总受孕率均高于对照组(P<0.05),两组宫外妊娠率比较无显著差异(P>0.05)。结论 给予行宫-腹腔镜手术的输卵管阻塞性不孕症患者宫安康、几丁糖联合治疗,可改善术后输卵管通畅情况,并能提高临床妊娠率,且可降低术后机体炎性因子水平。

Objective To explore the effects of hysteroscopy-laparoscopy combined with Gong′ankang(crosslinked sodium hyaluronate gel for uterine cavity)and chitosan therapy on postoperative tubal patency rate and clinical pregnancy in patients with tubal obstructive infertility.Methods A total of 94 patients with tubal obstructive infertility who were treated in Changsha Hospital for Maternal&Child Health Care from February 2020 to February 2022 were divided into control group and observation group by the random number table method,with 47 cases in each group.The control group received hysteroscopy-laparoscopy,and the observation group was given hysteroscopy-laparoscopy combined with Gong′ankang and chitosan therapy.The tubal patency and clinical pregnancy rate within 1 year after surgery and ovarian function indicators and inflammatory factors before and after surgery were compared between the two groups,and the incidence rates of postoperative complications were counted.Results The tubal patency degree in observation group was better than that in control group,and the tubal complete patency rate was higher than that in control group(P<0.05).The endometrial thickness at 3 months after surgery in both groups was thicker than that before surgery(P<0.05).The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)in observation group were lower compared with those in control group at 3 months after surgery(P<0.05).The intrauterine pregnancy rate and total conception rate in observation group were higher than those in control group(P<0.05),but there was no significant difference in the extrauterine pregnancy rate between the two groups(P>0.05).Conclusions The combined treatment with Gong′ankang and chitosan for patients with tubal obstructive infertility undergoing hysteroscopy-laparoscopy can improve the postoperative tubal patency,enhance the clinical pregnancy rate,and reduce the levels of postoperative body′s inflammatory factors.