近端输卵管闭塞的病理形态及其超微结构探讨  

Observation on the pathological morphous an ultrastructure of proximal oviduct occlusive infertility

作　　者：张帝开[1] 李秀云[1] 狄娜[1] 罗燕[1] 何钻玉[1] 杨冬梓[1] 邝健全[1] 吴金浪[2] 

机构地区：[1]中山大学第二附属医院妇产科,广东广州510120 [2]中山大学北校区电子显微镜室,广东广州510100

出　　处：《中国热带医学》2007年第4期584-587,共4页China Tropical Medicine

摘　　要：目的探讨近端输卵管闭塞的病理形态和超微结构。方法采用回顾性方法对1985年1月～2004年12月间182例近端输卵管闭塞性不孕症患者进行分析,主要是闭塞的近端输卵管的病理形态改变,部分输卵管标本行透射电镜观察。结果导致输卵管近端闭塞的首位病因是输卵管非特异性慢性炎症,占67.02%,其次是输卵管管腔纤维闭塞和结节性输卵管炎,各占11.54%,再次为输卵管子宫内膜异位症,占6.60%,输卵管结核、输卵管异物结节以及未见明显病变者各占1.10%。透射电镜发现4例患者阻塞段输卵管切面为大量胶原纤维和少量的纤维细胞,排列较为紊乱,未见上皮和管腔;有1例仍可见输卵管上皮,但纤毛互相粘连填塞管腔,致使管腔变窄甚至闭锁,部分细胞纤毛出现退化或脱落,纤毛的横切面9+2微管系统结构欠清晰,胞质内线粒体肿胀及内质网扩张,胞质内可见空泡。而邻近阻塞部位输卵管(通畅段):电镜下上皮细胞主要由单层柱状分泌细胞和纤毛细胞构成,纤毛细胞顶端的纤毛排列比较规整,未见明显退化和脱落的现象。结论闭塞的近端输卵管呈多种病理类型改变,其主要病因是输卵管非特异性慢性炎症,其次为输卵管管腔纤维闭塞和结节性输卵管炎。感染及人工流产的增加可能是导致输卵管性不孕发病率增加的因素。Objective To explore the pathological morphology and ultramicrostructure of proximal oviduct occlusive infertility. Methods One hundred and eighty - two proximal oviduct occlusive infertile women who were admitted to the second affiliated hospital of Yat - Sen University between 1985 and 2003 were included. Part of oviduct samples were examined by transmission electron microscope. Results The pathological morphology of proximal oviduct occlusion included non - specific chronic oviduct inflammation （67.02%）, lumens obliterative fibrosis（ 11.54% ） and nodular salpingitis（ 11.54% ）, endometriosis of fallopian tube（6.60% ）, tuberculosis, foreign substance and normal oviduct each occupied 1.10%. Conclusion There are all kinds of pathological changes in proximal oviduct occlusion. The major cause is non- specific chronic oviduct inflammation, and the secondary causes are lumens obliterative fibrosis and nodular salpingitis. Infection and artificial abortion may be the causes which resulted in increasing of tubal infertility.

关 键 词：近端输卵管 闭塞 病理 

分 类 号：R711.76[医药卫生—妇产科学]