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目的探讨宫腔镜下输卵管插管通液术对输卵管性不孕患者术后血液流变学及妊娠率的影响。方法选取2015年3月至2016年1月嘉应学院医学院附属医院收治的92例输卵管性不孕患者作为研究对象,按照手术方案不同分为对照组与研究组,各46例。对照组患者予以常规输卵管通液术,研究组患者采用宫腔镜下输卵管插管通液术进行治疗。比较两组患者输卵管通畅率、血液流变学指标(血浆黏度、全血低切黏度、全血高切黏度、血细胞比容)变化情况、并发症发生率,于1年后随访其妊娠率。结果研究组患者输卵管通畅率(89.1%)高于对照组(63.0%),差异有统计学意义(P<0.05);术后研究组患者血浆黏度、全血低切黏度、全血高切黏度、血细胞比容水平均明显低于对照组,差异均有统计学意义(均P<0.05);研究组患者并发症发生率(2.2%)低于对照组(21.7%),差异有统计学意义(P<0.05);研究组患者术后1年妊娠率(78.3%)高于对照组(54.3%),差异有统计学意义(χ2=5.886,P=0.015)。结论宫腔镜下输卵管插管通液术可提高输卵管性不孕患者妊娠率、输卵管通畅率,降低并发症发生率,改善血液流变学状态。
Objective To investigate the effect of hysteroscopic tubal catheterization on postoperative hemorheology and pregnancy rate in patients with tubal infertility. Methods From March 2015 to January 2016, 92 cases of tubal infertility patients admitted to the Affiliated Hospital of Jiaying College of Medicine were selected as study subjects, and divided into control group and study group according to the different surgical plans, with 46 cases in each group. Patients in the control group were given conventional tubal fluid, and patients in the study group were treated with hysteroscopic tubal intubation. The tubal patency rate, hemorheological parameters (plasma viscosity, whole blood low-cut viscosity, whole-blood high-cut viscosity and hematocrit) were compared between the two groups. The incidence of complications was compared. Results The fallopian tube patency rate (89.1%) in the study group was significantly higher than that in the control group (63.0%) (P <0.05). The plasma viscosity, whole blood low-cut viscosity, , Hematocrit levels were significantly lower than the control group, the difference was statistically significant (all P <0.05); the incidence of complications in study group (2.2%) was lower than that in control group (21.7%), the difference was statistically significant (P <0.05). The 1-year pregnancy rate (78.3%) in the study group was significantly higher than that in the control group (54.3%). The difference was statistically significant (χ2 = 5.886, P = 0.015). Conclusion Hysteroscopic tubal intubation can improve the pregnancy rate of tubal infertility, tubal patency rates, reduce the incidence of complications and improve the blood rheology.