摘要
目的观察核素显像示不同程度输卵管功能损伤患者经内科方法治疗后的妊娠情况，为不同损伤程度输卵管治疗方法的选择提供指导。方法回顾性分析改良^99TcmO4^-输卵管显像示至少一侧输卵管通畅的不孕症患者602例，根据输卵管功能损伤情况进行分级（轻度、中度、重度受损，无功能，阻塞），并对不同损伤程度患者采用内科方法（中药腹部热敷＋桂芝茯苓胶囊121服＋康妇消炎栓直肠给药）治疗后的妊娠情况进行对比分析。采用SPSS11．0软件对不同组间患者妊娠构成比的比较行x^2检验，并计算患者的治愈（输卵管功能恢复正常）率和有效（输卵管功能改善）率。结果患者经内科方法治疗1～6个疗程，87例（174条输卵管）有治疗前后显像，按条数计，其治愈率为29．5％（46／156），总有效率为71．8％（112／156），治疗前后均正常的输卵管未纳入统计。输卵管不同损伤程度组间妊娠构成比比较，其差异有统计学意义（，=166．4，P〈0．05）。输卵管功能一侧正常而另一侧不同程度受损（A）组，经内科方法治疗后自然妊娠率78．3％（144／184），较双侧功能均受损者明显增高[一侧轻度受损＋另一侧至少轻度受损（B）组、～侧中度受损＋另～侧至少中度受损（C）组、一侧重度受损＋至少一侧重度受损（D）组相应数据分别为52．6％（102／194）、42．6％（46／108）和13．8％（16／116）x^2=37．86、52．09和121．71，均P〈0．05]；B组和C组经内科方法治疗后自然妊娠率差异无统计学意义（x^2=3．29，P〉0．05）；而B组、C组与D组比较，差异均有统计学意义（x^2=67．29和42．82，均P〈0．05）。D组经内科方法治疗后，自然不孕者占32．8％（38／116），选择行试管婴儿者占53．4％（62／116），其中成功妊娠者占51．6％（32／62）。结论核素显像示输卵管功能轻度受损
Objective To observe the conception status of patients with fallopian tube dysfunction after medical treatment and to guide treatment strategy for patients with different degrees of tubal injury by radionue]ide imaging. Methods Six hundred and two patients with at least one side of patent fallopian tube underwent modified fallopian tube radionuclide imaging. The patients were graded as ： mild, moderate or se- vere injury, non-functioning or tubal obstruction. The conception status was analyzed after medical treat- ment, including abdominal hot pack with Chinese medicine, oral intake of Guizhi tuckahoe capsules, and Kangfu anti-inflammatory anal suppository. The constituent ratios of conception in different groups were com- pared using X2 test and the curative and effective rates were calculated. Results After 1 - 6 cycles of medi- cal treatment, patients with fallopian tube dysfunction had a curative rate of 29.5% （46/156） and effective rate of 71.8% （112/156）. There was a statistically significant difference among the different degrees of oviduct injury （X2 = 166. 4, P 〈 0.05 ）. After medical treatment, the natural pregnancy rate for patients with bilateral mild, moderate and severe injury was 52.6% （ 102/194 ）, 42.6% （46/108） and 13.8% （ 16/ 116） , respectively. The rate for patients with one side of normal tubal function was 78.3% （144/184） , which was significantly higher than that of patients with bilateral mild, moderate and severe injury （X2 = 37.86, 52.09 and 121.71, all P 〈 0.05 ）. The natural pregnancy rates of both mild and moderate injury groups were significantly different from the severe injury group （X2 = 67.29, 42.82, both P 〈 0.05 ） , but there was no difference between the mild and moderate injury groups （X2 = 3.29, P 〉 O. 05 ）. In the severe injury group, 32.8% （ 38/116 ） patients were naturally infertile after the medical treatment, while 53.4% （62/116） patients underwent in vitro fertilization （IVF） and 51.6% （ 32/62 ） of them
出处
《中华核医学与分子影像杂志》
CSCD
北大核心
2012年第6期434-437,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
山东省人口和计划生育委员会科学技术研究项目（2008年第20号）
关键词
输卵管疾病
不育
女性
放射性核素显像
锝
中草药
Fallopian tube diseases
Infertility, female
Radionuclide imaging
Technetium
Chinese herbal
