Kleinstein J, Kirschbaum M, Gips H, Künzel W
Universitäts-Frauenklinik Giessen.
Geburtshilfe Frauenheilkd. 1991 Aug;51(8):632-6. doi: 10.1055/s-2007-1026413.
The condition of the fallopian tubes was assessed in 100 fertile women on whom a caesarean section had been performed and in 100 infertile women who had undergone a diagnostic laparascopy. The 100 infertile women revealed both peritubal adhesions (20% vs 2%) and fimbrial agglutinations (4% vs 0%) in a significantly higher number of cases. When the diagnostic procedure was extended to include the salpingoscopy of 20 women with periampullary and peritubal adhesions, 10% of them were found to be suffering from damage of the endosalphinx. In patients with fimbrial agglutination, the same diagnostic procedure revealed mucosal damage in 40% of the cases. The rate of damage to the endosalpinx may help to explain the relatively high rate of ectopic pregnancies (15%) following microsurgical fimbrioplasty. Thus, in cases where the patient is suffering from peritubal adhesions and fimbrial agglutinations, salpinogoscopy can be of use in deciding whether microsurgery is indicated. In those cases, where there is evidence of damage to the endosalpinx, in-vitro fertilization with intrauterine embryo transfer must be considered as the preferential method.
对100例接受剖宫产的可育女性以及100例接受诊断性腹腔镜检查的不孕女性的输卵管状况进行了评估。100例不孕女性的输卵管周围粘连（20%对2%）和伞端粘连（4%对0%）病例数显著更多。当诊断程序扩展至对20例壶腹部周围和输卵管周围粘连女性进行输卵管镜检查时，发现其中10%存在输卵管内膜损伤。在伞端粘连患者中，同样的诊断程序显示40%的病例存在黏膜损伤。输卵管内膜损伤率可能有助于解释显微外科输卵管伞成形术后异位妊娠相对较高的发生率（15%）。因此，对于患有输卵管周围粘连和伞端粘连的患者，输卵管镜检查有助于决定是否需要进行显微手术。在那些有输卵管内膜损伤证据的病例中，必须考虑将体外受精联合宫腔内胚胎移植作为首选方法。
