输卵管显微外科吻合术113例临床分析

【目的】探讨输卵管显微外科吻合术的疗效及相关影响因素。【方法】回顾性分析113例行输卵管显微外科吻合术患者的临床病历资料及随访记录，观察其复通、妊娠结局及相关因素影响下的妊娠情况。【结果】术后输卵管通畅率99．12％，2年内妊娠率87．61％，宫内妊娠率85．84％，分娩率83．19％；各结扎年限术后妊娠率差异无统计学意义（ P ＞0．05）。潘氏法结扎者术后妊娠率明显低于抽芯包埋法和银夹法；壶腹‐伞部结扎者术后妊娠率明显低于其他部位结扎者；术后输卵管长度5 cm以内者妊娠率明显低于5 cm以上者，差异均有统计学意义（ P ＜0．05）。【结论】输卵管显微外科吻合术可有效复通输卵管，术后宫内妊娠率、分娩率均优异；绝育时结扎方法、部位及术后输卵管长度是影响吻合术后妊娠率的主要因素。

Clinical Analysis of 113 Cases of Microsurgical Anastomosis of Fallopian Tube

Objective]To explore the efficacy and the related factors of microsurgical anastomosis of fallo‐pian tube .Methods] Clinical data and visit records of 113 patients undergoing microsurgical anastomosis of fallopian tube were analyzed retrospectively .The recanalization of fallopian tube ,pregnancy outcome and the related factors of pregnancy were observed .Results] The recanalization rate of fallopian tube after operation was 99 .12% ,and the pregnancy rate was 87 .61% ,and the intrauterine pregnancy rate was 85 .84% ,and the delivery rate was 83 .19% within 2 years .There was no significant difference in ligation years and pregnancy rate after operation （ P 〉 0 .05 ） . The postoperative pregnancy rate of patients undergoing ligation with Pomeroy method was obviously lower than that of patients undergoing ligation with silver clip method and Ir‐ving method .The postoperative pregnancy rate of patients undergoing ligation of isthmus and umbrella was obviously lower than that of patients undergoing ligation in other positions .The pregnancy rate of patients with the length of fallopian tube less than 5cm after operation was obviously lower than that of patients with the length of fallopian tube more than 5cm .There were significant differences（ P 〈0 .05） .Conclusion] Mi‐crosurgical anastomosis of fallopian tube can efficiently re‐canalize fallopian tube ,and has good intrauterine pregnancy rate and delivery rate after operation .The ligation method ,ligation position and fallopian tubal length at sterilization are the major factors influencing the postoperative pregnancy rate .