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目的:探讨几丁糖预防输卵管阻塞手术复通后的粘连和炎性反应的临床效果。方法:选择输卵管阻塞手术复通120例,分成2组,60例几丁糖组在术中局部使用几丁糖防止粘连;对照组60例术中使用糜旦白酶、低分子佑旋糖酐、地塞米松。结果:术后3个月作HSG输卵管通畅度检查,几丁糖组通畅无粘连49例,占90.7%,5例再粘连,占9.3%,无一例输卵管积水;对照组通畅无粘连38例,占70.4%,再粘连16例,占29.6%,其中输卵管积水4例。术后一年受孕率随访,几丁糖组受孕32例,占59.2%,宫外孕3例,占5.6%;对照组受孕20例,占37.0%,宫外孕6例,占11.1%。两组通畅率、再粘连率和宫内受孕率有显著性差异。结论:几丁糖对预防术后再粘连,提高输卵管阻塞复通术的效果,具有明显的作用。
Objective: To investigate the clinical effect of chitosan preventing adhesions and inflammatory reaction after recanalization of tubal occlusion. Methods: One hundred and twenty cases of tubal occlusion were selected and divided into two groups. Chitosan group was used locally to prevent chondrocyte adhesion in the group of 60 chitin. In the control group, 60 cases were treated with minipain, low molecular weight polysaccharide ,Dexamethasone. Results: HSG tubal patency was detected 3 months after operation. The chitosan group showed no adhesions in 49 cases (90.7%) and reattached in 5 cases (9.3%). No tubal hydrops was found in the control group, and 38 cases in the control group had no adhesions , Accounting for 70.4%, then adhesion in 16 cases, accounting for 29.6%, of which 4 cases of hydrosalpinx. One year after the operation, the conception rate was followed up. Chitosan group had 32 cases of pregnancy (59.2%) and ectopic pregnancy (5.6%). The control group had 20 cases of pregnancy (37.0%) and ectopic pregnancy (11.1%). Two groups of patency rate, re-adhesion rate and intrauterine pregnancy rates were significantly different. Conclusion: Chitosan has a significant effect on the prevention of postoperative adhesions and improvement of tubal occlusion.