壳聚糖防止输卵管阻塞介入再通术后的复发性黏连

目的 评价壳聚糖(几丁糖)在输卵管介入再通术后防止复发性黏连的疗效.方法 309例患者随机分为对照组206例和试验组103例.对照组在输卵管阻塞介入复通术中常规注射松解液(α-糜蛋白酶、地塞米松、灭滴灵、庆大霉素)做术后防止黏连.试验组在术中常规注射松解液的基础上联合应用医用几丁糖防止黏连,术后通水治疗.随访观察两组病例松解输卵管的通畅情况.结果 试验组,经子宫输卵管碘水造影阻塞190条,缺如10条;介入复通188条,再通率为98.9%;术后随访3个月通水达到无阻力180条,再黏连率4.26%(8/188).对照组输卵管造影确认堵塞390条,缺如22条,复通385条,复通率为98.7%,术后随访3个月,通水达到无阻力330条,再黏连率14.28%(55/385).两组术后3个月再黏连率有差异(P＜0.01).结论 输卵管介入再通术后应用几丁糖能有效降低输卵管术后复发性黏连.

Study of chitosan in preventing recurrence of fallopian tube obstruction after recanalization

Objective To evaluate the efficacy of chitosan in preventing recurrence of fallopian tube obstruction.Methods A total of 309 cases was randomly divided into trial group(103 cases)and control group(206 cases).Cases of trial group were injected with chitosan especially and compared with the control group for preventing recurrence of fallopian tube obstruction after successful recanalization.A follow up examination of water insufflation was performed to assess the patency.Results In trial group,there were 190 obstructed fallopian tubes and 10 missing tubes,the recanalization rate was 98.9%(188/190).In control group,there were 390,and the recurrence rate was 4.26%(8/188).Fallopian obstructed tubes,and 22 missing tubes,the recanalization rate was 98.7%(385/390).After follow up of water insufflation 3 months,trial group had 180 tubes without resistance,and the recurrence rate was 4.26%(8/188),while control group had 330 tubes,and the recurrence rate was 4.28%(55/385).Recurrence rate of fallopian tube obstruction was significant difference between two groups(P＜0.01).Conclusion Chitosan infusion after interventional recanalization can reduce the recurrence of tube obstruction effectively.