Gerber B, Wilken H, Zacharias K, Barten G, Splitt G
Universitäts-Frauenklinik Rostock.
Geburtshilfe Frauenheilkd. 1992 Mar;52(3):165-70. doi: 10.1055/s-2007-1026119.
110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)
110例经腹腔镜检查确诊为输卵管炎且有生育意愿的患者,分别接受四环素(土霉素或强力霉素;TC)/甲硝唑治疗(n = 67)、阿莫西林治疗(n = 22)或环丙沙星/甲硝唑治疗(n = 21)。平均11.6周后,所有患者均接受了二次腹腔镜检查及输卵管通液术。在34例接受TC/甲硝唑治疗的患者中,研究了在温泉浴场常规条件下附加物理治疗措施的效果。33例未接受温泉疗法的患者作为对照。四组在平均年龄、百分比、未生育女性比例、淋菌性输卵管炎、避孕行为以及输卵管炎阶段方面均具有可比性(p>0.05)。所有使用的抗生素治疗方案均使炎症临床体征在五天后迅速减轻(体温、血沉、白细胞)。在温泉浴场接受附加治疗的34例患者中只有2例有不适主诉,而33例对照患者中有14例有不适主诉(p<0.01),接受阿莫西林治疗的22例中有7例(p<0.01),接受环丙沙星/甲硝唑治疗的21例中有7例(p<0.01)。输卵管阻塞率分别为33.3%(TC/甲硝唑)、32.3%(TC/甲硝唑加温泉疗法)、22.7%(阿莫西林)和23.8%(环丙沙星/甲硝唑)。差异无统计学意义(p>0.05)。关于粘连,首次腹腔镜检查和二次腹腔镜检查的结果同样无显著差异。得出结论,急性输卵管炎抗生素治疗后附加物理治疗措施可降低下腹部疼痛的频率,但不能改善输卵管阻塞情况及减少粘连。(摘要截短至250字)