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经阴道注水腹腔镜检查术改善生殖手术后远端输卵管阻塞患者的生育能力。

Intra-operative hydrotubation improves fertility of women with distal tubal occlusion after reproductive surgery.

机构信息

Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu 610041, People's Republic of China.

出版信息

Arch Gynecol Obstet. 2013 Jan;287(1):83-9. doi: 10.1007/s00404-012-2525-x. Epub 2012 Aug 30.

Abstract

PURPOSE

Hydrotubation has been considered to be a complimentary procedure to reproductive surgery, usually being conducted after surgery. The objective of this work was to assess the potential value of intra-operative hydrotubation in improving fertility of tubal infertile women.

METHODS

180 tubal infertile women were randomly assigned to one of the three groups: intra-operative hydrotubation (IH), post-operative hydrotubation (PH) or control group. In IH group, the hydrotubation was performed immediately after adhesiolysis during the surgery process, while in PH group it was performed within 3-7 days after the first post-operative menstruation. The incidence of post-operative pelvic infection and average hospitalization length were recorded. The post-operative pregnancy outcomes, including intrauterine pregnancy (IUP) rate and incidence of ectopic pregnancy, were recorded at 2 years follow-up.

RESULTS

No significant difference was found among the three groups, either in the incidence of pelvic infection (P = 0.877) or in the average hospitalization length (P = 0.596). At 2 years of follow-up, the rate of IUP in IH group was significantly higher than that in either PH or control group (P = 0.017 and 0.039, respectively), but no difference was observed between PH and control group (P = 0.752). No significant difference in the incidence of ectopic pregnancy was showed among three groups (P = 0.947).

CONCLUSIONS

The appropriate use of intra-operative hydrotubation can improve the post-operative IUP rate, serving as a complementary procedure for the surgical treatment of fertility reversal.

摘要

目的

输卵管插管通液术通常被认为是一种辅助生殖手术,通常在手术后进行。本研究旨在评估术中输卵管插管在改善输卵管性不孕患者生育能力方面的潜在价值。

方法

将 180 例输卵管性不孕患者随机分为三组:术中输卵管插管组(IH 组)、术后输卵管插管组(PH 组)和对照组。在 IH 组中,在手术过程中粘连松解后立即进行输卵管插管,而在 PH 组中,在第一次术后月经后 3-7 天内进行。记录术后盆腔感染的发生率和平均住院时间。术后 2 年随访时,记录妊娠结局,包括宫内妊娠(IUP)率和异位妊娠发生率。

结果

三组间盆腔感染发生率(P = 0.877)和平均住院时间(P = 0.596)差异均无统计学意义。术后 2 年随访时,IH 组 IUP 率明显高于 PH 组和对照组(P = 0.017 和 0.039),但 PH 组与对照组间差异无统计学意义(P = 0.752)。三组间异位妊娠发生率差异无统计学意义(P = 0.947)。

结论

术中适当使用输卵管插管可以提高术后 IUP 率,作为生殖手术治疗逆转生育能力的一种辅助手段。

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