三种输卵管疏通术治疗后发生输卵管妊娠的临床分析

Clinical Analysis of Tubal Pregnancy After Three Types of Tubal Recanalization Procedures

目的 :了解输卵管疏通术后发生输卵管妊娠的危险因素及其相应对策。方法 :回顾性分析 6 9例输卵管性不孕者分别经三种输卵管疏通术后发生输卵管妊娠 (TP)的患者 ,分成 3组 ,比较 3组疏通术前子宫输卵管碘油造影(HSG)结果和疏通术后通畅与非通畅输卵管的TP发生率。结果 :疏通术前 ,示输卵管柔软 5 7条 (34例 ) ,发生TP 2 1例(6 1.8% ) ,而欠柔软 /僵硬 79条 (5 6例 ) ,发生TP 4 8例 (85 7% ) ,两者差异有显著意义 (P <0 0 5 ) ;输卵管周围有无粘连者TP发生率差异也存在显著意义 (P <0 0 5 )。无论畅与不畅 ,3组术后TP发生率间差异无显著意义 (P >0 0 5 )。结论 :疏通术前HSG提示输卵管欠柔软、僵硬以及存在周围粘连者可能是疏通治疗后输卵管妊娠发生的危险因素。对于此类病变严重的输卵管不宜选择疏通术治疗。

Objective:To investigate the risk factors of tubal pregnancy(TP)after tubal recanalization and their related counterplot.Methods:Retrospectively analysed 69 TP (divided into three groups)who undergone three types of tubal recanalization for tubal infertility.Compared the incidence of TP referring to various tubal features observed at hysterosalpingography(HSG)before tubal recanalization,patency of tubes after tubal recanalization among three groups.Results:On HSG before tubal recanalization,there were 57 soft tubes (34 patients),about 21 patients occured TP (61.8%) There were 79 unsoftened or stiff tubes (56 patients),about 48 patients occurred TP(85.7%) There was a significant difference between them,( P <0.05).There was also significant difference concerning the incidence of TP with and without peritubal adhesions,( P <0.05).There was no significant difference concerning the incidence of TP regardless of patency or obstruction,in three groups( P >0.05).Conclusions:Unsoftened or stiff tubes and peritubal adhesions on HSG before tubal recanalization are the risk factors of TP after tubal recanalization.It is unsuitbal to select tubal recanalization as treatment for these severe defective tubes.