本文關(guān)鍵詞：盆腔粘連對(duì)輸卵管復(fù)通術(shù)及妊娠結(jié)局的影響　出處：《國際生殖健康/計(jì)劃生育雜志》2016年01期 　論文類型：期刊論文

  更多相關(guān)文章： 盆腔炎性疾病 不育 女(雌)性 輸卵管阻塞 腹腔鏡 宮腔鏡

【摘要】：目的:探討盆腔粘連對(duì)輸卵管近端阻塞和遠(yuǎn)端閉鎖復(fù)通術(shù)及妊娠結(jié)局的影響。方法:選擇1 038例因輸卵管性不孕接受宮-腹腔鏡聯(lián)合復(fù)通手術(shù)的患者,根據(jù)手術(shù)探查是否有盆腔粘連分為盆腔粘連組738例,對(duì)照組300例,分析2組患者輸卵管近端阻塞率、遠(yuǎn)端閉鎖復(fù)通率和妊娠結(jié)局。結(jié)果:盆腔粘連組輸卵管遠(yuǎn)端閉鎖率較對(duì)照組高(42.3%vs.14.5%,P=0.000,OR=4.32,95%CI:3.02~6.17),2組輸卵管近端阻塞率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。但是盆腔粘連組輸卵管近端阻塞復(fù)通率低于對(duì)照組(59.3%vs.75.5%,P=0.005,OR=0.47,95%CI:0.28~0.80),2組輸卵管遠(yuǎn)端閉鎖的復(fù)通率相似(84.2%vs.86.0%,P0.05)。盆腔粘連組宮內(nèi)妊娠率低于對(duì)照組(22.6%vs.39.6%,P0.001,OR=0.444,95%CI:0.282~0.698),而術(shù)后異位妊娠率高于對(duì)照組(7.2%vs.2.7%,P=0.02),尤其是Ⅲ度粘連患者異位妊娠率較對(duì)照組高(12.0%vs.2.7%,P=0.01,OR=4.62,95%CI:1.29~16.50)。對(duì)于單純遠(yuǎn)端輸卵管閉鎖和合并近端遠(yuǎn)端輸卵管病變的患者來說,復(fù)通術(shù)后2年仍未妊娠的患者合并盆腔粘連的比例高于成功獲得宮內(nèi)妊娠者(94.4%vs.82.1%,91.8%vs.67.3%,P0.05),但是在單純輸卵管近端阻塞患者中未發(fā)現(xiàn)這一現(xiàn)象。結(jié)論:盆腔粘連降低了輸卵管近端阻塞的復(fù)通率,同時(shí)降低輸卵管遠(yuǎn)端閉鎖患者復(fù)通術(shù)后的宮內(nèi)妊娠率,并增加術(shù)后異位妊娠的風(fēng)險(xiǎn)。
[Abstract]:Objective: to investigate the effect of pelvic adhesion on proximal tubal obstruction, distal atresia and pregnancy outcome. According to the surgical exploration of pelvic adhesions, 738 cases were divided into pelvic adhesions group and 300 cases in control group. The rate of proximal tubal obstruction in two groups was analyzed. Results: the rate of distal tubal atresia in pelvic adhesion group was higher than that in control group. 95 CI: 3.02 6.17). However, the recanalization rate of proximal tubal obstruction in pelvic adhesions group was lower than that in control group (59.3 vs 75.5%). The recanalization rate of the atresia of distal fallopian tube in group I: 0.28 and 0.80 was similar to that of 84.2% vs 86.0%. The intrauterine pregnancy rate in pelvic adhesions group was lower than that in control group (22.6vs.39.6). The rate of ectopic pregnancy after operation was higher than that of the control group (Vs.2.7P0.02). In particular, the ectopic pregnancy rate in the patients with degree 鈪，

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