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目的 :研究影响输卵管结扎后吻合成功的因素。方法 :随访 1991年 1月至 1999年 6月行输卵管结扎术后吻合术 (PTLA)的 198例 ,分析影响PTLA成功的因素。结果 :随访 175例 ( 88 38% ) 1年以上 ,其中PTLA成功 170例 ( 97 14% ) ;妊娠141例 ( 80 57% ) ,包括 1例宫外孕 ,术后 1年内妊娠 116例 ( 82 2 7% )。影响PTLA成功的因素有 ( 1)从输卵管结扎至吻合术的时间 :<5年妊娠率为 79 76% ,≥ 5年妊娠率 81 32 % ,差异无显著性 (P >0 0 5) ;( 2 )输卵管结扎方式 :采用抽芯包埋法结扎者妊娠率为 82 14% ,采用Pomeroy改良法者妊娠率为 79 12 % ,差异无显著性 (P >0 0 5) ;( 3)输卵管吻合方式 :峡部 -峡部吻合者妊娠率为 92 96% ,壶腹部 -壶腹部吻合者妊娠率为 71 4 3% ,峡部 -壶腹部吻合者妊娠率为 71 4 3% ,前者与后两者差异有显著性 (P <0 0 5) ;( 4 )吻合术后输卵管长度 :两侧输卵管≥ 5cm者妊娠率为82 76% ,其中一侧输卵管≥ 5cm者妊娠率为 81 92 % ,两侧输卵管均 <5cm者妊娠率为 37 5% ,前两者差异无显著性 ,前两者与后者差异有显著性 (P <0 0 5) ;( 5)吻合术者输卵管有无异常 :术前输卵管有异常者妊娠率为 70 9% ,无异常者为 89 89% ,差异有显著性 (P <0 0 5) ;( 6)吻合术后是否放支架 ,术后未?
Objective: To study the factors affecting the success of tubal ligation after tubal ligation. Methods: A total of 198 patients with postoperative tubal ligation (PTLA) from January 1991 to June 1999 were followed up and the factors affecting the success of PTLA were analyzed. Results: A total of 175 patients (88 38%) were followed up for more than 1 year, of which 170 (97.14%) had successful PTLA and 141 (80 57%) pregnancies, including 1 case of ectopic pregnancy, 116 cases of pregnancy within 1 year %). The factors influencing the success of PTLA were: (1) the time from tubal ligation to anastomosis: <5 years pregnancy rate was 79 76%, ≥ 5 years pregnancy rate was 81 32%, there was no significant difference (P> 0.05); 2) Tubal ligation: The pregnancy rate was 82.14% with lumbar traction and ligation, and the pregnancy rate was 79.12% with Pomeroy modified method, with no significant difference (P> 0.05); (3) tubal anastomosis Methods: The pregnancy rate was 92.96% in isthmus - isthmus anastomosis, 71.43% in ampulla - ampulla anastomosis, 71.43% in isthmus - ampulla anastomosis, the difference between the former and the latter was (P <0.05); (4) tubal length after anastomosis: the pregnancy rate was 82.76% on both sides of tubal≥5cm, the pregnancy rate was 81.92% on one side of tubal≥5cm, <5cm, the pregnancy rate was 37.5%, the difference between the former two was insignificant, the former two had significant difference with the latter (P <0 05); (5) Anastomosis tubal abnormalities: preoperative tubal The abnormal pregnancy rate was 70.9%, no abnormality was 89.89%, the difference was significant (P <0 05); (6) whether the stent was placed after anastomosis, postoperative?