盆腔粘连对输卵管复通术及妊娠结局的影响

发布时间：2018-01-17 12:59

  本文关键词：盆腔粘连对输卵管复通术及妊娠结局的影响　出处：《国际生殖健康/计划生育杂志》2016年01期 　论文类型：期刊论文

  更多相关文章： 盆腔炎性疾病 不育 女(雌)性 输卵管阻塞 腹腔镜 宫腔镜

【摘要】：目的:探讨盆腔粘连对输卵管近端阻塞和远端闭锁复通术及妊娠结局的影响。方法:选择1 038例因输卵管性不孕接受宫-腹腔镜联合复通手术的患者,根据手术探查是否有盆腔粘连分为盆腔粘连组738例,对照组300例,分析2组患者输卵管近端阻塞率、远端闭锁复通率和妊娠结局。结果:盆腔粘连组输卵管远端闭锁率较对照组高(42.3%vs.14.5%,P=0.000,OR=4.32,95%CI:3.02~6.17),2组输卵管近端阻塞率差异无统计学意义(P0.05)。但是盆腔粘连组输卵管近端阻塞复通率低于对照组(59.3%vs.75.5%,P=0.005,OR=0.47,95%CI:0.28~0.80),2组输卵管远端闭锁的复通率相似(84.2%vs.86.0%,P0.05)。盆腔粘连组宫内妊娠率低于对照组(22.6%vs.39.6%,P0.001,OR=0.444,95%CI:0.282~0.698),而术后异位妊娠率高于对照组(7.2%vs.2.7%,P=0.02),尤其是Ⅲ度粘连患者异位妊娠率较对照组高(12.0%vs.2.7%,P=0.01,OR=4.62,95%CI:1.29~16.50)。对于单纯远端输卵管闭锁和合并近端远端输卵管病变的患者来说,复通术后2年仍未妊娠的患者合并盆腔粘连的比例高于成功获得宫内妊娠者(94.4%vs.82.1%,91.8%vs.67.3%,P0.05),但是在单纯输卵管近端阻塞患者中未发现这一现象。结论:盆腔粘连降低了输卵管近端阻塞的复通率,同时降低输卵管远端闭锁患者复通术后的宫内妊娠率,并增加术后异位妊娠的风险。
[Abstract]:Objective: to investigate the effect of pelvic adhesion on proximal tubal obstruction, distal atresia and pregnancy outcome. According to the surgical exploration of pelvic adhesions, 738 cases were divided into pelvic adhesions group and 300 cases in control group. The rate of proximal tubal obstruction in two groups was analyzed. Results: the rate of distal tubal atresia in pelvic adhesion group was higher than that in control group. 95 CI: 3.02 6.17). However, the recanalization rate of proximal tubal obstruction in pelvic adhesions group was lower than that in control group (59.3 vs 75.5%). The recanalization rate of the atresia of distal fallopian tube in group I: 0.28 and 0.80 was similar to that of 84.2% vs 86.0%. The intrauterine pregnancy rate in pelvic adhesions group was lower than that in control group (22.6vs.39.6). The rate of ectopic pregnancy after operation was higher than that of the control group (Vs.2.7P0.02). In particular, the ectopic pregnancy rate in the patients with degree 鈪，

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