改良双腔球囊导管在插管失败的输卵管阻塞介入再通术中的应用价值

目的探讨改良双腔球囊导管在插管失败的输卵管阻塞介入再通术中的应用价值。方法回顾45例输卵管阻塞性不孕患者,应用常规法行介入再通术,其中输卵管开口插管失败采用改良双腔球囊导管行介入再通,统计分析常规法组与联合改良双腔球囊导管法组(联合法组)的输卵管开口插管成功率、输卵管阻塞的开通率。结果输卵管阻塞性不孕患者45例,共阻塞输卵管90条,采用常规法输卵管开口插管成功32条,其中开通成功31条,插管成功率为35.56%,开通率96.88%。采用联合法输卵管开口插管成功90条,输卵管开通83条,插管成功率为100%,开通率92.22%,7条输卵管因阻塞病情严重无法开通,其中双侧均未能开通1例。所有患者术中均无严重并发症发生。随访12个月,妊娠率48.65%。常规法组与联合法组输卵管开口插管成功率差异具有统计学意义(χ^2=85.574,P=0.000),而输卵管开通率差异无统计学意义(χ^2=0.248,P=0.619)。结论对于常规法输卵管开口插管失败者,采用联合改良双腔球囊导管可提高输卵管开口插管成功率。采用改良双腔球囊导管介入再通与常规法开通效果相当,可作为常规介入再通输卵管开口插管失败的备选方案。

Application Value of Modified Double-lumen Balloon Catheter in Interventional Recanalization of Fallopian Tube Obstruction with Failed Intubation

Objective To explore the application value of modified double-lumen balloon catheter in interventional recanalization of fallopian tube obstruction with failed intubation.Methods A retrospective analysis was conducted on 45 cases in which modified double-lumen balloon catheter was used for the failure of tubal orifice intubation in the treatment of the conventional recanalization from December 2015 to October 2017 in our hospital.The success rate of tubal orifice intubation and the opening rate of tubal obstruction by conventional method and combined method which combined use of modified double-lumen balloon catheter(combined method)were counted.Results There were 45 cases of tubal obstruction with 90 blocked fallopian tubes,of which 32 tubes were successfully intubated by conventional method,and 31 tubes which were opened.The success rate of intubation was 35.56%,and the success rate of opening was 96.88%.By the combined method,90 fallopian tubes were successfully intubated,83 of which were successfully unblocked.The success rate of intubation was 100.00%,and the success rate of opening was 92.22%.Seven fallopian tubes could not be opened due to severe obstruction.Two tubes which were found in one case failed to be opened.No serious complications occurred for all patients during the operations.The patients were followed up for 12 months,and the pregnancy rate was 48.65%.There was a statistical difference in the intubation rate between the conventional method group and the combined method group(χ^2=85.574,P=0.000),but there was no statistical difference in the tubal opening rate(χ^2=0.248,P=0.619).Conclusion The combination of improved double-lumen balloon catheter can improve the success rate of intubation for those tubes which would have failed to be intubated by the conventional method.The effect of interventional recanalization with modified double-lumen balloon catheter is comparable to that of the conventional method.It can be used as an alternative for the failure of tubal orifice intubation in the treatment of the conventional recanalization and is worthy of clinical application.