几种防粘连剂在输卵管复通术中防治术后再粘连的对比研究  

Comparative Research of Chitosangroup,Sodium Hyaluronate,and Chymotrypsin for Peventing Fallopian Tube Adhension after Salpingostomy

作　　者：赵波[1] 韦多发 

机构地区：[1]云南省第二人民医院放射科,云南昆明650021 [2]云南玛莉亚医院放射科,云南昆明650051

出　　处：《昆明医学院学报》2010年第9期67-69,共3页Journal of Kunming Medical College

摘　　要：目的探讨几丁糖、玻璃酸钠、糜蛋白酶在输卵管复通术后防治再粘连的临床疗效.方法将1 364例不孕症输卵管阻塞患者,随机分为三组,几丁糖组463例,共894条输卵管,玻璃酸钠组448例.852条输卵管,糜蛋白酶组453例,635条输卵管,介入开通术后,每条输卵管均先注入地塞米松5 mg,庆大霉素8万U,林可霉素0.6 g,再分别注入几丁糖2 mL,玻璃酸钠2.5 mL,糜蛋白酶4 000 U,术后1个月行两次通水治疗,随访术后通畅率及怀孕率.结果术后3个月内几丁糖组通畅率为91.3%(816/894),玻璃酸钠组为86.7%(739/852),糜蛋白酶组为43%(273/635);术后12个月内妊娠率几丁糖组72.5%(336/463),玻璃酸钠组67.4%(302/448),糜蛋白酶组32.1%(179/453),怀孕率及通畅率几丁糖组与玻璃酸钠组差异无统计学意义(P>0.05),但与糜蛋白酶组差异有统计学意义(P<0.05).结论输卵管介入开通术后,注入几丁糖、玻璃酸钠、糜蛋白酶均能减少输卵管再粘连的发生,而几丁糖、玻璃酸钠效果较好,对提高输卵管阻塞介入开通术后的妊娠几率具有显著效果.Objective To discuss the clinical therapeutic effect of Chitosangroup,Sodium hyaluronate,and Chymotrypsin for preventing fallopian tube adhension again after salpingostomy.Methods We randomy divided 1 364 patients with infertilitas into three groups：Chitosan group（463 cases and 894 pieces of salpingemphraxis）,Sodium hyaluronate group（448 cases and 852 pieces of salpingemphraxis）,and Chymotrypsin group（453 cases and 635 pieces of salpingemphraxis）.After the operation of the intervention removement,each fallopian tube was injected 5 mg dexamethasone,80 000 U gentamicin,0.6 g lincomycin,then 2 mL Chitosangroup,2.5 mL Sodium hyaluronate and 4 000 U Chymotrypsin.One month later,the patients were cured with antibiotic two times and checked the rate of patency and pregnancy.Results Three months later,the patency rate was 91.3%（816/894）in Chitosan group,86.7%（739/852）in Sodium hyaluronate group,and 43%（273/635）in Chymotrypsin group.In the following twelve months,the pregnancy rate was 72.5%（336/463）in Chitosan group,67.4%（302/448）in Sodium hyaluronate group,and 32.1%（179/453）in Chymotrypsin group.There was no significant statistical difference in the rate of patency and pregnancy between Chitosan group and Sodium hyaluronate group.However,there was a significant statistical difference between Chymotrypsin group and the former two groups（P0.05）.Conclusion Injecting Chitosangroup,Sodium hyaluronate,Chymotrypsin after the operation of saplingostomy can reduce the rate of fallopian tube adhension again,but the effects of Chitosangroup and Sodium hyaluronate are better than Chymotrypsin and they can improve the level of pregnancy rate.

关 键 词：几丁糖 玻璃酸钠 糜蛋白酶 介入再通 粘连 

分 类 号：R816.91[医药卫生—放射医学]