输卵管伞端造口术、盆腔粘连松解术联合输卵管通液治疗对输卵管炎性阻塞性不孕患者的疗效  

Curative effect of tubal fimbriostomy,pelvic adhesion-lysis combined with tubal fluid in the treatment of infertile patients with salpingitis

作　　者：孙瑞清 连雪君 张婷 张巧愉 李玉萍 SUN Rui-qing;LIAN Xue-jun;ZHANG Ting;ZHANG Qiao-yu;LI Yu-ping(Department of Gynecology,the 73rd Army Hospital of the Chinese People s Liberation Army,Xiamen 361001,Fujian,China)

机构地区：[1]中国人民解放军陆军第七十三集团军医院妇科,福建厦门361001

出　　处：《川北医学院学报》2025年第3期349-352,共4页Journal of North Sichuan Medical College

基　　金：福建省厦门市医疗卫生指导项目(3502Z202009163)。

摘　　要：目的:探讨输卵管伞端造口术、盆腔粘连松解术联合输卵管通液对输卵管炎性阻塞性不孕患者的疗效。方法:选取120例输卵管炎性阻塞性不孕患者作为研究对象,依据治疗方式不同将患者分为观察组(n=62)和对照组(n=58)。对照组患者接受输卵管通液治疗;观察组患者接受输卵管伞端造口术、盆腔粘连松解术与输卵管通液联合治疗。比较两组患者输卵管通畅率、临床妊娠率和围术期性激素[促黄体激素(LH)、促卵泡激素(FSH)、雌二醇(E_(2))]水平、血液流变指标[血浆黏度、低切黏度、红细胞沉降率(ESR)]和炎症指标[肿瘤坏死因子α(TNF-ɑ)、C反应蛋白(CRP)]及术后并发症发生情况。结果:观察组患者输卵管通畅率、自然妊娠率高于对照组(P<0.05);异位妊娠发生率低于对照组(P<0.05)。术后1个月,观察组患者LH、FSH、血浆黏度、低切黏度、ESR、TNF-ɑ、CRP水平均低于对照组(P<0.05);血清E_(2)水平高于对照组(P<0.05)。两组患者术后并发症发生率无统计学差异(P>0.05)。结论:输卵管伞端造口术和盆腔粘连松解术联合输卵管通液治疗输卵管炎性阻塞性不孕,可有效修复盆腔结构,改善炎症,促进性腺分泌功能恢复,提高输卵管通畅率和临床妊娠率。Objective:To evaluate the therapeutic effect of fimbriostomy of tubal tube and pelvic adhesion-lysis in combination with tubal fluid drainage on infertile patients with salpingitis.Methods:120 patients with salpingitis obstructive infertility who met the inclusion and exclusion criteria were divided into observation group(n=62) and control group(n=58) according to different treatment methods.The control group was treated with tubal drainage,and the observation group was treated with fimbal end ostomy,pelvic adhesion lysis and tubal drainage.The tubal patency rate,clinical pregnancy rate,perioperative sex hormones [luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E_2)],hemorheological indexes [plasma viscosity,low shear viscosity,erythrocyte sedimentation rate(ESR)]and inflammatory indexes [tumor necrosis factor alpha(TNF-ɑ),C-reactive protein(CRP)],and the incidence of postoperative complications of the two groups before and after treatment were compared.Results:The tubal patency rate and natural pregnancy rate in the observation group were higher than those in the control group,and the ectopic pregnancy rate was lower(P<0.05).1 month after surgery,compared with the control group,serum LH and FSH concentrations and serum E_(2) concentrations in the observation group were lower,plasma viscosity,low tangent viscosity,erythrocyte sedimentation rate(ESR) and serum Tumor necrosis factor(TNF-α)/C-reactive protein(CRP) were lower,and the differences were statistically significant(P<0.05).There was no significant difference in the postoperative complication rate between the observation group and the control group(P>0.05).Conclusion:Fimbriostomy of tubal tube and pelvic adhesion lysis combined with tubal fluid can effectively repair the pelvic structure,improve inflammation,promote the recovery of gonadal secretion function,improve the tubal patency rate and clinical pregnancy rate.

关 键 词：输卵管炎性阻塞性不孕 输卵管通液 输卵管伞端造口术 盆腔粘连松解术 疗效观察 

分 类 号：R711.6[医药卫生—妇产科学]