介入再通术与宫腔镜、腹腔镜联合治疗输卵管近端阻塞的对比研究

目的比较介入再通术与官腔腹、腹腔镜联合导丝疏通治疗输卵管近端阻塞的临床价值。方法子宫输卵管造影显示为双侧输卵管近段阻塞的不孕症患者，根据患者的要求随机分为2组。A组104例X线下行介入输卵管再通治疗术；B组48例行宫腔腹、腹腔镜联合导丝疏通治疗输卵管治疗术。结果A组输卵管的再通率88．2％（179／203），B组为90．4％（85／94）；13个月后输卵管的再阻塞率A组为16．8％（30，179），B组为14．1％（12／85）；随访1年，两组宫内妊娠率A组26．7％（20／75），B组29．8％（14／47）；输卵管妊娠率A组2．7％（2／75），B组2．1％（1／47）。结论选择性输卵管介入再通术能复通大部分输卵管近端阻塞，可作为有效治疗方法之一。

Comparative study on interventional recanalization and laparoscopy combined with hysteroscopy for proximal tubal obstruction

Objective To compare the clinical effects of interventional recanalization and laparoscopy combined with hysteroscopy for treatment of proximal tubal obstruction. Methods Interventional recanalization （Group A）and laparoscopy combined with hysteroscopy （Group B ）for proximal tubal obstruction were performed for 104 and 44 infertile cases with fallopian tubes obstruction diagnosed by hystero-salpingography （HSG） and studied respectively. Results 88.2% （ 179/203 ）of fallopian tubes were recanalizated in group A and and 90.4% （85/94）in group B. The fallopian tubes reocclusion rate was 16.8% （30/179） and 14.1% （ 12/85 ）in group A and group B respectively 13 months later. In one years follow-up, uterine pregnancy occurred in 26. 7% （20/75）of patients in group A and 29.8% （ 14/47）of patients in group B, and tubal pregnancy occurred in 2.7% （2/75）of patients in group A and 2.1% （ 1/47）of patients in group B. Conclusion Selective salpingography can recanalized the obstructive fallopian tube in majority of proximal occlusions and should be the first choice of therapy.