本文選題：改良導(dǎo)管 + 輸卵管阻塞�。� 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：[目的]：探討改良導(dǎo)管介入治療輸卵管阻塞性不孕癥的臨床研究。 [方法]：回顧性分析山西醫(yī)科大學(xué)第一醫(yī)院與山西現(xiàn)代婦產(chǎn)醫(yī)院介入科2012年1月至2013年12月收治的經(jīng)子宮輸卵管造影診斷輸卵管阻塞不孕患者198例,年齡22-43歲,平均年齡32歲,不孕平均年限2-6年,其中原發(fā)性不孕82例,繼發(fā)性不孕116例,198例患者共387條輸卵管不同部位阻塞(其中有7例因輸卵管宮外孕術(shù)后切除一條輸卵管,單角子宮2例),輸卵管近段阻塞(間質(zhì)部與峽部)263條,輸卵管遠(yuǎn)端阻塞(壺腹部與傘端)124條。經(jīng)改良導(dǎo)管介入治療輸卵管阻塞觀察其再通率,并通過隨訪記錄妊娠情況。 [結(jié)果]：387條阻塞輸卵管經(jīng)改良導(dǎo)管再通治療后,其中263條輸卵管近段阻塞疏通252條,再通率95.8%,失敗13條,失敗率為4.94%；124條輸卵管遠(yuǎn)端阻塞疏通98條,再通率79%,失敗26條,失敗率為20.97%；總共疏通350條,總疏通率90.4%。輸卵管近端疏通率明顯高于遠(yuǎn)端疏通率(卡方檢驗,P0.05),有統(tǒng)計學(xué)差異。術(shù)后隨訪不孕患者162例1-24個月(2012年1月至2014年2月),共妊娠63例,妊娠率38.9%,其中1例胎停育,3例輸卵管妊娠。 [結(jié)論]：與專用輸卵管再通導(dǎo)管比較,改良導(dǎo)管介入治療輸卵管阻塞不孕癥患者具有相似的再通率和宮內(nèi)妊娠率,輸卵管近端(間質(zhì)部、峽部)阻塞疏通率明顯高于遠(yuǎn)端(壺腹部、傘端)阻塞疏通率,再通術(shù)后1年內(nèi)宮內(nèi)妊娠率明顯高于1年以上宮內(nèi)妊娠率。應(yīng)用改良導(dǎo)管行輸卵管阻塞介入治療,療效可靠,取材方便,經(jīng)濟實用,插管容易,操作時間短,并發(fā)癥更少,為基層醫(yī)院使用簡便經(jīng)濟的介入器材治療輸卵管阻塞提供理論依據(jù),可以廣泛應(yīng)用于基層醫(yī)院和經(jīng)濟困難患者。
[Abstract]:Objective: to explore the clinical study of modified catheter interventional therapy for oviduct obstructive infertility. [methods] 198 patients with infertility diagnosed by hysterosalpingography from January 2012 to December 2013 in the first Hospital of Shanxi Medical University and the Interventional Department of Shanxi Modern Obstetral Hospital were retrospectively analyzed, aged 22-43 years with an average age of 32 years. The average age of infertility was 2 to 6 years. Among them, 82 cases were primary infertility, and 198 cases were secondary infertility. There were 387 tubal obstruction (7 of them were resected one oviduct due to ectopic pregnancy of fallopian tube after operation. There were 2 cases of monogonium with proximal tubal obstruction (263 tubal and isthmus) and 124 distal tubal obstruction (ampulla and umbrella end). The recanalization rate of tubal obstruction was observed by modified catheter intervention, and pregnancy was recorded by follow-up. [results] after treatment with modified catheterization, 263 of 387 obstructed fallopian tubes were recanalized with 252 of them, the recanalization rate was 95.855, the failure rate was 13, the failure rate was 4.94124, the recanalization rate was 79 and 26, respectively. The failure rate was 20.97; the total number of dredges was 350 and the total dredging rate was 90.4. The recanalization rate of proximal fallopian tube was significantly higher than that of distal tube (chi-square test P 0.05, P < 0.05). 162 infertile patients were followed up for 1-24 months (from January 2012 to February 2014), 63 cases were pregnant, the pregnancy rate was 38.9%, and 3 cases of tubal pregnancy were stopped in 1 case. [conclusion]: compared with the special tubal recanalization catheter, the recanalization rate and intrauterine pregnancy rate of the patients with sterility caused by tubal obstruction by modified catheter interventional therapy are similar, the tubal proximal end (interstitial part), The obliteration rate of isthmus was significantly higher than that of distal ampulla, and the rate of intrauterine pregnancy was significantly higher than that of intrauterine pregnancy more than one year after recanalization. The modified catheter was used to treat fallopian tube obstruction with reliable curative effect, convenient sampling, economical and practical, easy intubation, short operation time and less complications. It provides a theoretical basis for the treatment of fallopian tube obstruction with simple and economical interventional equipment in primary hospitals and can be widely used in basic hospitals and patients with economic difficulties.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R711.6;R816.91

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