不留支架输卵管直视吻合术277例报告

对２７７例作不留支架输卵管直视吻合术者随访，经通液试验，复通率９０．０６％（２５１／２７７）；术后宫内妊娠２３９例，异位妊娠２例，复孕率８７％（２４１／２７７）。吻合手术成功率与原输卵管结扎术式、吻合部位、年龄以及术后通液等因素有密切关系。原采用银夹法输卵管复通术的妊娠率为９６．６７％（２９／３０），高于其他术式；峡部对峡部吻合者的妊娠率为９３．３８％（１２１／１２９），显著高于其他部位吻合者；年龄在３５岁以下组输卵管复通后妊娠率为９０．６１％（２２２／２４５），显著高于３５岁以上组。认为不留置支架吻合并不影响手术成功率，可以避免输卵管解剖变形和异物感染；术后通液是提高复孕率的重要环节。

Anastomosis of fallopian tube under direct vision without retaining stand: Report of 277 cases

77 cases were followed up. Patent recovery rate was 90.06%(251/277) with tubal patent test by liquid instillation. Pregnant recovery rate was 87.00%(241/277), among which there were 239 cases of postoperative uterine pregnancy and 2 cases of heterotopic pregnancy. The success rate of anastomosis was closely related to the original types of ligation of fallopian tubes, anastomotic parts, ages and postoperative tubal patency by liquid instillation. The pregnancy rate after salpingostomy with original silver clip method was 96.67%, which was higher than that in the other types. Pregnancy rate in isthmus to isthmus anastomosis was 93.38%(121/129), much higher than that in the anastomosis of other parts. Pregnancy rate after salpingostomy in group under 35 years old was 90.61%(222/245), much higher than that in group over 35. It is thought that anastomosis without retaining stand would not affect the success rate of the operation. It can avoid the anatomical deformation of oviduct and foreign body infection. The operative tubal patency by liquid instillation is a key link in rising pregnancy recovery rate.