影响输卵管吻合术成功因素的分析

目的 :研究影响输卵管结扎后吻合成功的因素。方法 :随访 1991年 1月至 1999年 6月行输卵管结扎术后吻合术 (PTLA)的 198例 ,分析影响PTLA成功的因素。结果 :随访 175例 ( 88 38% ) 1年以上 ,其中PTLA成功 170例 ( 97 14% ) ;妊娠141例 ( 80 57% ) ,包括 1例宫外孕 ,术后 1年内妊娠 116例 ( 82 2 7% )。影响PTLA成功的因素有 ( 1)从输卵管结扎至吻合术的时间 :<5年妊娠率为 79 76% ,≥ 5年妊娠率 81 32 % ,差异无显著性 (P >0 0 5) ;( 2 )输卵管结扎方式 :采用抽芯包埋法结扎者妊娠率为 82 14% ,采用Pomeroy改良法者妊娠率为 79 12 % ,差异无显著性 (P >0 0 5) ;( 3)输卵管吻合方式 :峡部 -峡部吻合者妊娠率为 92 96% ,壶腹部 -壶腹部吻合者妊娠率为 71 4 3% ,峡部 -壶腹部吻合者妊娠率为 71 4 3% ,前者与后两者差异有显著性 (P <0 0 5) ;( 4 )吻合术后输卵管长度 :两侧输卵管≥ 5cm者妊娠率为82 76% ,其中一侧输卵管≥ 5cm者妊娠率为 81 92 % ,两侧输卵管均 <5cm者妊娠率为 37 5% ,前两者差异无显著性 ,前两者与后者差异有显著性 (P <0 0 5) ;( 5)吻合术者输卵管有无异常 :术前输卵管有异常者妊娠率为 70 9% ,无异常者为 89 89% ,差异有显著性 (P <0 0 5) ;( 6)吻合术后是否放支架 ,术后未?

Analysis of influencing factors in the success of fallopian tube anastomosis

Objective:To study the influencing factors in the success of past-tubal ligation anastomosis (PTAL).Methods:198 cases who underwent PTLA from Jan.1991 to Jun.1990 were followed up,and the factors which influenced the success of PTLA were analysed.Results:175 cases(88.38%)were followed up for one year or more,170 cases(97.27%)were success in PTLA;141 cases(80.57%)got pregnancy,including one ectopic pregnancy,and 116 cases(82.27%)got pregnancy in first year after anastomosis.The influencing factors in the success of PTLA are(1)The duration from tubal ligation to anastomsis:The pregnant rate in patienes whose duration less than 5 years was 79.76%,it was 81.32% in 5 years or more,there was no signficant difference (P>0.05);(2)The means of tubal ligation:The pregnant rate in patients with wrapping way was 82.14%,it was 79.12% in improred Pomeroy′s way,there was no signficant difference (P>0.05);(3)The means of anastomosis:The pregnant rate in patients with isthmus-istlmus way was 92.96%,it was 71.43% in ampulla-ampulla way,it was 71.43% in isthmusampulla way,there was significant difference between the first and others (P>0.05);(4)The tubal length after anastomosis:The pregnant rate in patients whose both tubal length 5cm or more was 82.76%,it was 81.82% in single tube 5cm or more,it was 37.50% in both tube less than 5cm,there was no significant difference between the first two (P>0.05),there was significant difference between the first two and the last (P<0.05);(5)The abnomal tubes before anastomosis:The pregnant rate in patients with abnomal tubes was 70.93%,it was 89.89% in nomal ones,there was siginficant difference(P<0.05);(6)The tubal stand after anastomosis:The pregnant rate in patients with no stand was 80.57%,it was 63.70% in ones with stand,there was significant difference(P<0.05).Conchusions:The facors that influeuce the success of PTLA are complex,and some factors are variable.The impvorement of technology in PTLA will increase the pregnant rate.