宫腔镜下输卵管介入加中药灌肠并理疗治疗输卵管阻塞的临床研究

目的：采取宫腔镜下输卵管介入配合中药灌肠、理疗治疗输卵管阻塞，探讨综合治疗榆卵管阻塞的有效方法。方法：选择2012年4月～2014年4月经子宫输卵管造影（HSG）证实输卵管阻塞患者98例，随机分为治疗组50例、对照组48例，统一采用宫腔镜下输卵管介入术，治疗组术后2d行中药灌肠结合理疗治疗1疗程，对照组不做治疗。两组均于下次月经净后3-7天，行HSG复查，对比其治疗效果。结果：输卵管再通率：手术中治疗组与对照组分别是94．56％、94．38％，无显著差异（P〉0．05）；下次月经净后HSG复查输卵管通畅率：治疗组与对照组分别是88．04％，69．66％，有显著差异（P〈0．05）；再粘连率：治疗组与对照组分别是6．89％、26．19％，有极显著差异（P〈0．01）；妊娠率：治疗组与对照组分别是32％、12．5％，有显著差异（P〈0．05）；异位妊娠发生率：治疗组与对照组分别是0、33．33％，有显著差异（P〈0．05）。结论：宫腔镜下输卵管介入是治疗输卵管阻塞的直接手段，中药灌肠结合理疗能有效防止已疏通输卵管再粘连，使输卵管尽快恢复畅通、蠕动、拾卵功能，是综合治疗输卵管阻塞的有效方法。

Clinical research on treatment of fallopian tube obstruction by hysteroscopic tubal intervention combined with physiotherapy and enema with Chinese medicine

Objective： To investigate the curative method ofhysteroscopic tubal intervention combined with enema with Chinese medicine and physiotherapy. Methods： 98 cases with fallopian tube obstruction confirmed by HSG from April, 2012 to April, 2014 were selected and randomly divided into a treatment group with 50 cases and a control group with 48 cases. All the patients were treated with hysteroscopic tubal intervention, and the treatment group were given a course of physiotherapy and enema with Chinese medicine after 2 days, while the control group not. All the patients in the two groups were retested HSG at 3-7 days after menstruation and the curative efficacy was compared. Results： Fallopian tube recanalization rate： for the treatment group and the control group respectively in surgery, 94.56%, 94.38% without significant differences （P 〉 0.05 ） ; HSG retested fallopian tube recanalization rate after menstruation： for the treatment group and the control group, 88.04%, 69.66% with significant differences （P 〈 0.05 ）; Adhesion rate： for the treatment group and the control group, 6.89%, 26.19% with extremely obvious difference （P 〈 0.01 ） ; Pregnancy rate： for the treatment group and the control group, 32%, 12.5% with significant differences （P 〈 0.05 ） ; The incidence rate of ectopic pregnancy：for the treatment group and the control group,0. 33%, 33% with significant differences （P 〈 0.05 ） .Conclusion： Hysteroscopic tubal intervention is the direct therapy for fallopian tube obstruction and enema with Chinese medicine and physiotherapy can effectively prevent the adhesion of dredged tubes in order to recover its function of smoothening, peristalsis, picking up ovum, which is an effective comprehensive treatment of fallopian tube obstruction.