曾宇^1,,
范新²,
林琳¹,
赵琳^1,3,,
1. 大连医科大学附属第二医院 妇产科, 辽宁 大连 116027
2. 大连医科大学附属第二医院 影像科, 辽宁 大连 116027
3. 南京医科大学附属苏州科技城医院 妇产科, 江苏 苏州 215153

基金项目: 辽宁省科学技术计划项目（201602246）；大连市医学科学研究计划项目资助（1612025）


详细信息 作者简介: 曾宇(1995-), 女, 硕士研究生。E-mail: 951174010@qq.com




通讯作者: 赵琳, 主任医师。E-mail: zhaolin5517@hotmail.com 中图分类号: R7133.7


摘要:目的探讨选择性输卵管插管疏通术（selective hydrotubation，SHT）的临床疗效及其影响因素。方法收集2015年6月至2019年6月行选择性输卵管插管疏通术治疗的58例诊断为输卵管近端阻塞患者的临床资料，包括不孕时间（< 3年或≥3年）、不孕类型（原发或继发）、是否有支原体感染、输卵管阻塞数量和程度、是否患有其他妇科合并症以及手术方式，分析术后的临床疗效并对其影响因素进行单因素和多因素分析。结果选择性输卵管插管疏通术疏通成功率97%，总妊娠率41.4%。已孕组24例，未孕组34例，单因素分析表明输卵管近端完全性阻塞的患者术后妊娠率高于不完全阻塞者（χ²=7.643，P=0.006），原发性不孕患者术后妊娠率高于继发性不孕者（χ²=5.170，P=0.023），而患者年龄、手术方式、生殖道感染、输卵管阻塞个数以及是否有其他妇科合并症不影响术后妊娠率（P>0.05）。与单因素分析相同，多因素分析表明输卵管近端完全性阻塞的患者术后妊娠率高于不完全阻塞者（OR=3.671，P=0.035），但不孕类型不影响术后妊娠率（P=0.395）。结论选择性输卵管插管疏通治疗是治疗输卵管近端梗阻的有效方法，输卵管完全梗阻的病人术后更容易受孕。
关键词: 选择性输卵管插管疏通/
不孕症/
临床疗效


Abstract:ObjectiveTo study the influencing factors and clinical efficacy of selective hydrotubation (SHT).MethodsWe retrospectively analyzed the data of 58 patients with selective hydrotubation from June 2015 to June 2019, including time of infertility(less than 3 years or 3 years and above), type of infertility (primary or secondary), mycoplasma infection, number and degree of fallopian tube obstruction, other gynecological complications and the method of surgery. Clinical efficacy of surgery was analyzed. Univariate factor and multiple factor analyses were performed to identify the influencing factors.ResultsThe success rate of SHT was 97% with a total pregnancy rate of 41.4%, including 24 cases in the pregnant group and 34 cases in the non-pregnant group. Univariate analysis revealed that the patients with complete tubal obstruction had better postoperative pregnancy rate than those with incomplete obstruction (χ²=7.643, P=0.006). The patients with primary infertility had better efficacy than those with secondary infertility (χ²=5.170, P=0.023). The patients' age, surgical method, type of infertility, reproductive tract infection, number of tubal obstructions, and presence/absence of other gynecological complications had no significant correlation with postoperative pregnancy rate (P>0.05). Similar to univariate analysis, multivariate analysis demonstrated that the patients with complete tubal obstruction had better postoperative pregnancy rates than those with incomplete obstruction (OR=3.671, P=0.035); however, the type of infertility did not affect postoperative pregnancy rates (P=0.395).ConclusionSelective hydrotubation is an effective method for the treatment of proximal tubal obstruction. Patients with complete tubal obstruction are more likely to conceive after surgery.
Keywords:selective hydrotubation/
infertility/
clinical efficacy

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