显微输卵管吻合术10年回顾

目的探讨几种常见输卵管绝育手术后进行显微输卵管吻合术，并观察其临床疗效及影响因素。方法回顾分析1997年2月～2007年4月间我站200例妇女输卵管绝育后进行显微复通手术的效果，对不同绝育方法的复通效果及相关影响因素进行分析比较。结果200例复通术的患者随访182例，随访率91．0％。复通术后6个月受孕率最高为32．50％（65／200）。抽芯包埋法和银夹绝育复通术后宫内妊娠率显著高于其他方法（P〈0．05）；吻合术后输卵管长度〈4cm时宫内妊娠率显著降低，长度〉6cm时宫内妊娠率即不受影响。结论外科显微吻合技术明显提高手术后输卵管复通率与术后妊娠率。绝育时减少输卵管系膜损伤，可提高术后复通的成功率，抽芯包埋法和银夹法复通术复通效果较好；加用粘合剂可明显提高术后早期宫内妊娠率。吻合后输卵管的长度、患者的年龄、绝育年限都是重要影响因素。

Review of microsurgical tubal reversal after tubal sterilization in the past decade

Aim To study the effects of microsurgical tubal reversal in women with various common tubai sterilization techniques, and observe its clinical curative effect and the related factors. Methods Two hundred women who underwent microsurgical tubal reversal after tubal sterilization in Public Service Station of Family planning of Zongyang County from 1997 to 2007 were followed up to observe the reversal resuhs. The reversal resuhs of different sterilizing techniques and the influencing factors were compared and analyzed. Results One hundred and eighty-two women（91.10% ） with tubal reversal were successfully followed up. The pregnancy rate in 6 months after tubal reversal was the highest（32.50% ,65 /200）. The rates of intrauterine pregnancy after tubal reversal in Uchida sterilization technique and clips sterilization were significantly higher than those in other sterilizing techniques （ P 〈 0.05 ）. When the tubal length after anastomosis was less than 4 cm, the intrauterine pregnancy rate was very low. When the tubal length was more than 6cm, the reversal resuh will not be impaired. Conclusion The micro surgery through fallopian tube greatly improve pregnancy after the operation. The tubal sterilization with a little destruction can be more reversible after micro surgery. The Uchida sterilization technique and clips sterilization were better than other sterilization techniques. To use adhesive material can greatly improve intrauterine pregnancy after opration in earlier period. The length of tubal reversal, the time of sterilization and the ages of patients are the most influencing factors.