宫腔镜下输卵管插管通液治疗输卵管阻塞性不孕的效果及对子宫动脉血流参数的影响  

Effect of Hysteroscopic Tubal Catheterization and Hydrotubation on Tubal Obstructive Infertility and Its Impact on Uterine Artery Blood Flow Parameters

作　　者：张立敬 胡晓丽 王海波 李萍 逯彩虹 赵霞 ZHANG Lijing;HU Xiaoli;WANG Haibo;LI Ping;LU Caihong;ZHAO Xia(Department of Obstetrics and Gynecology,the Affiliated Hospital of Non-Commissioned Officer School,Army Military Medical University,Shijiazhuang 050000,China)

机构地区：[1]陆军军医大学士官学校附属医院妇产科,石家庄050000

出　　处：《临床误诊误治》2025年第4期66-70,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省2021年度医学科学研究课题计划(20211370)。

摘　　要：目的探究宫腔镜下输卵管插管通液治疗输卵管阻塞性不孕的效果及对子宫动脉血流参数的影响。方法选取2019年3月至2021年6月收治的输卵管阻塞性不孕患者236例。依据随机数字法分为CG组、EG组,每组118例,CG组给予传统输卵管通液治疗,EG组给予宫腔镜下输卵管插管通液术治疗。评估2组患者临床疗效、子宫动脉血流参数、应激反应指标、并发症发生率及术后随访1年妊娠情况。结果EG组治疗总有效率97.46%(115/118)高于CG组81.36%(96/118,P<0.05)。术后3 d,2组患者超敏C反应蛋白水平均较术前升高,但EG组低于CG组(P<0.05)。术后,2组患者子宫动脉阻力指数及收缩期峰值流速/舒张末期流速值均低于术前,且EG组低于CG组(P<0.05),但搏动指数组间及组内比较均无显著差异(P>0.05)。EG组术后并发症总发生率低于CG组(P<0.05)。EG组术后1年妊娠率高于CG组,平均妊娠时间短于CG组(P<0.05)。结论宫腔镜下输卵管插管通液治疗输卵管阻塞性不孕患者,可提高再通率,优化子宫动脉血流,增加妊娠率,且创伤较小,术后应激反应轻,同时能降低并发症发生率。Objective To explore the effect of hysteroscopic tubal catheterization and hydrotubation on tubal obstructive infertility and its impact on uterine artery blood flow parameters.Methods A total of 236 patients with tubal obstructive infertility treated from March 2019 to June 2021 were selected.According to random number method,the patients were divided into CG group and EG group,with 118 patients in each group.The CG group was given traditional tubal fluid catheterization and hydrotubation,and the EG group was given hysteroscopic tubal catheterization and hydrotubation.The clinical efficacy,uterine artery blood flow parameters,stress response indicators,complication rate and 1-year follow-up pregnancy of the two groups were evaluated.Results The total effective rate of EG group was 97.46%(115/118),which was higher than that of CG group 81.36%(96/118,P<0.05).At 3 d after surgery,the level of hypersensitive C-reactive protein in the two groups was higher than that before surgery,which,however,was lower in EG group than in CG group(P<0.05).After surgery,uterine arterial resistance index and the value of peak systolic flow velocity/end-diastolic flow velocity in the two groups were lower than those before surgery,and lower in EG group than in CG group(P<0.05),but there were no significant intergroup and intragroup differences in pulse index(P>0.05).The total incidence of postoperative complications in EG group was lower than that in CG group(P<0.05).The pregnancy rate one year after operation in EG group was higher than that in CG group,and the mean pregnancy time was shorter than that in CG group(P<0.05).Conclusion In the treatment of patients with tubal obstructive infertility,hysteroscopic tubal catheterization and hydrotubation can improve the recurrence rate,optimize the uterine artery blood flow,increase the pregnancy rate,with minimal trauma and mild postoperative stress response,and reduce the incidence of complications.

关 键 词：输卵管阻塞性不孕 宫腔镜 输卵管通液 子宫动脉 血流参数 超敏C反应蛋白 并发症 妊娠 

分 类 号：R711.6[医药卫生—妇产科学]