改良诊疗器在输卵管阻塞性不孕症造影及再通术中的应用研究

目的评价两种不同诊疗器进行选择性输卵管造影（selective salpingography，SSG）和输卵管再通术（fallopian tube recanalization，FTR）在输卵管阻塞性不孕症中的诊治价值。方法将268例输卵管阻塞性不孕症患者随机分为2组，分别应用美国COOK公司的输卵管同轴导管导丝（A组，102例）和自制改良子宫输卵管诊疗器（B组，166例）进行选择性输卵管造影和再通术，统计1年内的妊娠率和输卵管通畅度治疗的有效率。结果输卵管复通率A组患者合计198条输卵管，复通率为85．9％（170／198），B组合计320条输卵管，复通率为90．6％（290／320），两组复通率比较差异有统计学意义。A组共计受孕率为35．3％（36／102），B组总计受孕率为47．6％（79／166），二者差异有统计学意义。结论选择性输卵管造影和输卵管再通术对输卵管性不孕有诊断和治疗的双重作用，改良子宫输卵管诊疗器简便，疗效更可靠。

Clinical application of selective salpingography and fallopian tube recanalization in diagnosis and treatment for obstructive infertility

Objective To evaluate the significance of selective salpingography(SSG)and fallopian tube recanalization(FTR)in diagnosis and treatment for obstructive infertility.Methods Totally, 268women with infertility caused by obstruction of the fallopian tube were divided randomly into two groups, one (Group A)with a non-operative hysterosalpingeal system by insertion of co-axial cannula and guiding filament made by COOK Corporation in the US and another(Group B)with a self-prepared hysterosalpingeal system modified based on the apparatus of COOK Corporation, for SSG and FTR.Then, efficacy of SSG and FTR for the infertile women was evaluated by one-year cumulative pregnancy rate and reeanalization rate of the fallopian tube.Resnits One hundred and seventy of 198 fallopian tubes were recanalized in Group A, with a recanalization rate of 85.8%, and 290 of 320 tubes in Group B were recanalized.with a recanalization rate of 90.6%.reaching statistically significant difference.Furthermore, recanalization rate varied with different sites of occlusion of the fallopian tube.Pregnancy rate was 35.3%(36/102)in Group A, significantly higher than that in Group B(47.6%, 79/166).As the same, pregnancy rate varied with different sites of occlusion of the fallopian tube.Conclusion Selective salpingography and fallopian tube recanalization with self-prepared hysterosalpingeal system have dual effects on diagnosis and treatment for tubal infertility of women, which are simpler, safer and more reliable, worth to be clinically applied.