输卵管阻塞介入再通术后应用透明质酸钠防止复发性粘连的探讨

目的 评价输卵管介入再通术后使用透明质酸钠防止复发性粘连的疗效和价值。方法分为实验组(103例)和对照组(208例)前者行输卵管阻塞介入复通术后常规注射医用透明质酸钠作防止粘连，后者行输卵管阻塞介入复通术常规使用DXM、α-糜蛋白霉、灭滴灵、庆大霉素作术后防止粘连。观察两组病例在术后、复发再塞的情况，随访术后2～3个月的通水受孕率宫外孕及足月妊娠分娩情况。结果 实验组103例经子宫输卵管碘水造影阻塞190条，缺如10例，介入复通188条，再通率为99％，术后随访2～3个月通水达到无阻力99例，对照组206例中输卵管阻塞造影确认堵塞390条，缺如27例，复通385条，复通率为99％，术后随访2—3个月，通水达到无阻力为178例，术后再粘连有显著性差异。结论 输卵管介入再通术后使用透明质酸钠是能有效阻止术后再粘连阻塞复发的措施。

An evaluation of sodium hyaluronate in preventing recurrence of tubal obstruction after interventional recanalization

Objective To evaluate the efficacy and application of sodium hyaluronate in preven ting the re-currence of tubal obstruction after interventional recanalization.Methods In total 103cases of the study group w ere injected sodium hyaluronate to prev ente tubal adhering obstruction after successful recanalization,whil e in the control group 206cases were injected desame thasone,alphacutanee,metronidazol and gentamycin for the same purpose.Both groups were followed up in 2-3months after the initial intervention.The assessments included water insufflation,intrauterine pregnancy rate,ectopic pregnancy rate and the norma l labor.Results In the study group,190tubes in 103cases were obstructed,27tubes missing,and 188tubes were recanalized out of 190(99%).In the control group 390tubes were obstructed,27tubes missing,385tubes were successfully rec analized(99%).In the 2-3month follow up water insufflation showed satisfyi ng patency in 99cases in the study gro up,and in 178cases in the control gro up.Significant difference of recurren ce rate of tubal obstructions was found between the two groups.Conclusion Sodium hualuronate is effective to prevent the recurrence of tubal obstruction after interventional recanalization.