透明质酸钠在阻塞性输卵管介入再通术中的应用

目的研究透明质酸钠防治输卵管粘连阻塞的临床疗效。方法358例输卵管阻塞患者分对照组(245例)和研究组(113例)。对照组经导管、导丝将阻塞输卵管开通后,注入松解液:庆大霉素、α-糜蛋白酶、地塞米松、利多卡因做消炎灌注治疗。研究组在对照组治疗基础上,再注入医用透明质酸钠预防复发粘连。随访术后3个月的通水通畅率,观察两组病例在术后复发再阻塞的情况,患者半年内受孕率。结果研究组113例经子宫输卵管碘水造影,10条输卵管因手术缺如,阻塞216条,介入复通210条,再通率为97.2%(210/216);术后随访3个月通水达到无阻力108例,占95.6%(108/113)、发生再粘连5例,占4.4%(5/113)。对照组245例中输卵管堵塞441条,单侧切除后输卵管缺如49条,复通428条,复通率为97.1%(428/441);术后随访3个月,通水达无阻力214例,占87.3%(214/245)、发生再粘连31例,占12.7%(31/245)。两组术后再粘连比较差异有统计学意义。术后6个月内研究组有39例、对照组有56例患者妊娠,妊娠率分别为34.5%(39/113)和22.8%(56/245),两组比较差异有统计学意义。结论输卵管再通术后使用透明质酸钠能有效防止输卵管再粘连阻塞的发生。

The role of sodium hyaluronate in preventing recurrence of tubal obstruction after interventional repatency

Objective To evaluate the efficacy of sodium hyaluronate in preventing recurrence of tubal obstruction. Methods Three hundred and fifty-eight cases were divided into two groups. The patients in research group (n=113) were given sodium hyaluronate for preventing recurrence of tubal adherence and obstruction after successful recanalization,while in the comparison group(n=245) were given dexamethasone,alphacutanee, metronidazol and gentamycin for the same purpose. Both groups received follow-up examination with water insufflation, intrauterine pregnancy rate.Results In the research group, 113 cases with 216 tubes obstructed, with 10 tubes missing , got recanalization in 210 tubes (97.2%). In comparison group 441 tubes obstructed, 49 tubes missing, got recanalization in 428 tubes (97.1%). During the 3 month follow-up of water insufflation,there were in the research group 108 cases(95.6%)with satisfactory waterpassing,while the comparison group 214 cases(87.3%).Recurrence rate of tubal obstruction was significantly different from each other in the two groups. The cyesis rates in the research and control groups were 34.5%,22.8% respectively. Conclusion Sodium hyaluronate is effective in preventing the recurrence of tubal obstruction after interventional recanalization.