改良导管介入治疗输卵管阻塞性不孕症的临床研究

发布时间：2018-05-24 20:58

本文选题：改良导管 + 输卵管阻塞　；参考：《山西医科大学》2014年硕士论文

【摘要】：[目的]：探讨改良导管介入治疗输卵管阻塞性不孕症的临床研究。 [方法]：回顾性分析山西医科大学第一医院与山西现代妇产医院介入科2012年1月至2013年12月收治的经子宫输卵管造影诊断输卵管阻塞不孕患者198例,年龄22-43岁,平均年龄32岁,不孕平均年限2-6年,其中原发性不孕82例,继发性不孕116例,198例患者共387条输卵管不同部位阻塞(其中有7例因输卵管宫外孕术后切除一条输卵管,单角子宫2例),输卵管近段阻塞(间质部与峡部)263条,输卵管远端阻塞(壶腹部与伞端)124条。经改良导管介入治疗输卵管阻塞观察其再通率,并通过随访记录妊娠情况。 [结果]：387条阻塞输卵管经改良导管再通治疗后,其中263条输卵管近段阻塞疏通252条,再通率95.8%,失败13条,失败率为4.94%；124条输卵管远端阻塞疏通98条,再通率79%,失败26条,失败率为20.97%；总共疏通350条,总疏通率90.4%。输卵管近端疏通率明显高于远端疏通率(卡方检验,P0.05),有统计学差异。术后随访不孕患者162例1-24个月(2012年1月至2014年2月),共妊娠63例,妊娠率38.9%,其中1例胎停育,3例输卵管妊娠。 [结论]：与专用输卵管再通导管比较,改良导管介入治疗输卵管阻塞不孕症患者具有相似的再通率和宫内妊娠率,输卵管近端(间质部、峡部)阻塞疏通率明显高于远端(壶腹部、伞端)阻塞疏通率,再通术后1年内宫内妊娠率明显高于1年以上宫内妊娠率。应用改良导管行输卵管阻塞介入治疗,疗效可靠,取材方便,经济实用,插管容易,操作时间短,并发症更少,为基层医院使用简便经济的介入器材治疗输卵管阻塞提供理论依据,可以广泛应用于基层医院和经济困难患者。
[Abstract]:Objective: to explore the clinical study of modified catheter interventional therapy for oviduct obstructive infertility. [methods] 198 patients with infertility diagnosed by hysterosalpingography from January 2012 to December 2013 in the first Hospital of Shanxi Medical University and the Interventional Department of Shanxi Modern Obstetral Hospital were retrospectively analyzed, aged 22-43 years with an average age of 32 years. The average age of infertility was 2 to 6 years. Among them, 82 cases were primary infertility, and 198 cases were secondary infertility. There were 387 tubal obstruction (7 of them were resected one oviduct due to ectopic pregnancy of fallopian tube after operation. There were 2 cases of monogonium with proximal tubal obstruction (263 tubal and isthmus) and 124 distal tubal obstruction (ampulla and umbrella end). The recanalization rate of tubal obstruction was observed by modified catheter intervention, and pregnancy was recorded by follow-up. [results] after treatment with modified catheterization, 263 of 387 obstructed fallopian tubes were recanalized with 252 of them, the recanalization rate was 95.855, the failure rate was 13, the failure rate was 4.94124, the recanalization rate was 79 and 26, respectively. The failure rate was 20.97; the total number of dredges was 350 and the total dredging rate was 90.4. The recanalization rate of proximal fallopian tube was significantly higher than that of distal tube (chi-square test P 0.05, P < 0.05). 162 infertile patients were followed up for 1-24 months (from January 2012 to February 2014), 63 cases were pregnant, the pregnancy rate was 38.9%, and 3 cases of tubal pregnancy were stopped in 1 case. [conclusion]: compared with the special tubal recanalization catheter, the recanalization rate and intrauterine pregnancy rate of the patients with sterility caused by tubal obstruction by modified catheter interventional therapy are similar, the tubal proximal end (interstitial part), The obliteration rate of isthmus was significantly higher than that of distal ampulla, and the rate of intrauterine pregnancy was significantly higher than that of intrauterine pregnancy more than one year after recanalization. The modified catheter was used to treat fallopian tube obstruction with reliable curative effect, convenient sampling, economical and practical, easy intubation, short operation time and less complications. It provides a theoretical basis for the treatment of fallopian tube obstruction with simple and economical interventional equipment in primary hospitals and can be widely used in basic hospitals and patients with economic difficulties.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.6;R816.91

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