输卵管阻塞性不孕症宫、腹腔镜术后治疗方法的探讨

目的:探讨输卵管阻塞性不孕症宫、腹腔镜术后阻止再次粘连和阻塞的诊疗方法。方法:将宫、腹腔镜术后至少一侧输卵管通畅的不孕症患者随机分为治疗组和对照组,治疗组和对照组分别术后第1次月经干净后3~7 d应用欣可聍或注射体积分数20%甲硝唑氯化钠注射液进行彩色B超监测下宫腔镜输卵管插管通液;观察术后1年的妊娠情况,术后1年未孕者,于月经干净后3~7 d行子宫输卵管碘佛醇造影检查,了解输卵管通畅度。结果:术后1年治疗组妊娠率(68.75%)高于对照组(51.25%),差异有统计学意义(χ2=5.104,P=0.024);异位妊娠差异无统计学意义(P0.05);未孕者治疗组双侧输卵管通畅率(40.9%)高于对照组(14.2%),差异有统计学意义(χ2=5.168,P=0.023)。结论:输卵管阻塞性不孕症宫、腹腔镜术后第1次月经干净后3~7 d用欣可聍注射液进行彩色B超监测下宫腔镜输卵管插管通液,可以降低盆腔的再次粘连,维持输卵管的通畅,提高受孕率,值得临床推广应用。

Discussion about the Follow-up Treatment on Salpinx Obstructive Infertility Postoperation of Hysteroscopy Combined Laparoscopy

Objective： To evalueate about the follow-up treatment methods on salpinx obstructive infertilitypostoperation ofhysteroscopy combined laparoscopy. Methods： The infertility patients postoperation by hysteroscopy combined laparoscopy with at least one side fallopian tube patency were randomly divided into two groups.The study group will be clean application hin can ceruminous injection under hysteroscopic tubal intubation fluid after 3-7 d after the first menstrual cycle ofpostoperation, control group with 20% metronidazole and sodium chlorideinjection, observation of postoperative pregnancies a year. The unpregnancy patients were given Ioversol check to observe the influence of Fallopian tube. Results： The pregnancy rate after one year was 68.75% in study group,which was higher than that in the control （51.25%）, the difference was statistically significant （X^2=5.104, P=-0.024）. Ectopic pregnancy had no statistically significant difference （P〉0.05）. Bilateral fallopian tube patency rate ofunfertilized cases was 40.9%, which was higher than that in the control （14.2%）, the difference was statistically significant （X^2=5.168, P=0.023）. Conclusion： Hin ceruminous injection with salpinx obstructive infertility postoperationofhysteroscopy combined laparoscopy for the first time can be 3-7 d after menstruation for color B ultrasonic monitoring under hysteroscopic tubal intubation liquid, can reduce pelvic adhesion, again to maintain tubal pa-tency and improve the conception rate. It＇s useful for the follow-up treatment on salpinx obstructive infertility postoperation ofhysteroscopy combined laparoscopy.