形状记忆镍钛合金输卵管绝育夹的临床与兔实验研究

Shape Memory Titanium Alloy Clip for Female Sterilization

形状记忆镍钛合金输卵管绝育夹可在4℃冰水内用小血管钳分开两臂,避开血管置于输卵管峡部,浇以30℃～40℃温盐水,两臂立即自动关闭。自1982到1987年作夹绝育术1,002例,上夹时及术后无痛感。无系膜撕裂血肿,无术后感染等并发症。经随访3.5～9年,有12例失败复孕,纠正失败率为0.89%。随访月经改变仅占6.38%。91例合金夹绝育妇女测黄体中期血孕酮及雌二醇,与21例正常妇女组及27例结扎组比较,孕酮值在合金夹组及正常妇女组相似(p>0.05),而结扎组明显低于前二组(p<0.01)。说明卵巢功能在合金夹绝育妇女改变较结扎组少。在动物实验经扫描电镜发现夹破坏输卵管粘膜仅1^+mm,夹旁粘膜皆为正常纤毛及分泌细胞,说明其可复性好。

From 1982 to 1987. shape memory titanium alloy clips were employed for female sterilization by minilaparotomy in 1002 cases. This clip was noncorrosive and had high histocompatibility. The clip was designed to open in ice water 0～4℃ and close at 30～40℃ spontaneously. It was placed vertically over the isthmus 3 cm away from the uterine cornus avoiding blood vessels in the mesosalpinx. Clip application was painless and without complications. On follow-up, only 6.3% had mild menstrual disturbances. The failure rate was 0.89%. Mid-luteal progesterone (P) and estradiol (E_2) were determined in 91 clip patients. Twenty one normal women and 27 cases of tubal ligation served as controls. The serum P levels were similar in clip cases and normal controls. There were significant differences in serum P between clip and tubal ligation groups. SEM examination of rabbit tube with clip showed limited destruction of the tubal mucosa with normal cilia and cells at the border. The clip produced little disturbances in the ovarian blood supply and least destruction of the tubal mucosa.