不孕症患者盆腔粘连的影响因素调查及对输卵管再通的影响

目的 分析不孕症患者盆腔粘连的影响因素,观察盆腔粘连对输卵管再通的影响.方法 收集386例输卵管阻塞性不孕症患者临床资料,粘连组进行输卵管再通术和腹腔镜分离粘连术,对照组进行输卵管再通术.观察输卵管再通和妊娠结局.结果 流产、异位妊娠、盆腔疾病史和宫腔操作史是不孕症患者盆腔粘连的主要影响因素(P均＜0.05).异位妊娠次数、盆腔疾病率及宫腔操作次数与盆腔粘连程度呈正相关,粘连组再通率低于对照组(P均＜0.05),12个月后粘连组和对照组正常妊娠、异位妊娠、流产率、再次阻塞率的差异显著,不同粘连程度以上指标的差异显著(P均＜0.05).结论 流产、异位妊娠、盆腔疾病史和宫腔操作史是不孕症患者盆腔粘连的主要影响因素,盆腔粘连导致输卵管再通率低,术后12个月正常妊娠率低,流产、异位妊娠、再次阻塞风险高.

The influencing factors of infertility patients with pelvic adhesions and fallopian tube recanalization

Objective To analyze the impact factors of infertility patients with pelvic adhesions, observed the effects of pelvic adhesions of fallopian tube recanalization. Methods Collected the clinical data of 386 cases of tubal obstruction infertility patients, divided into adhesions group and control group, adhesions group fallopian tube recanalization sepa- ration of adhesions and laparoscopic surgery, the control group fallopian tube recanalization. Fallopian tube reeanal ization was observed and pregnancy outcomes. Results Case of infertility 〉10 years were more, previous miscarriage, induced abortion, ectopic pregnancy, pelvic disease history and the uterine cavity operation history with higher propor- tion （P〈0.05）. Miscarriage, ectopic pregnancy, pelvic disease history and the history of the uterine cavity operation infertility were main factors of pelvic adhesions （P〈O.05）. Fercentage differences of different levels of adhesion ectopic pregnancy, pelvic disease, uterine operation were statistically significant, the frequency of ectopic pregnancy ,the pelvic disease rate and uterine number of operations and pelvic adhesions were positively correlated （P〈O.05）, recanalization rate of adhesions group were lower than the control group （P〈0.05）, adhesion and control groups after 12 months of normal pregnancy, ectopic pregnancy, miscarriage rate, again blocking rate, the difference were statistically significant （P〈0.05）, differences of them among different degree of adhesion were statistically significant （P〈0.05）. Conclu-sion Miscarriage, ectopic pregnancy, pelvic disease history and the uterine cavity operation history are the main factors affecting of infertility patients with pelvic adhesions. Fallopian tube recanalization rate of pelvic adhesions and normal pregnancy rate after 12 months are low, risks of abortion, eetopic pregnancy, obstruction again are high.