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目的观察硬膜外导管支架应用于输卵管中远段再通术中的效果。方法将硬膜外导管头端从输卵管伞端插入至输卵管吻合断端,再经近端管腔至子宫腔内,以此为支架,缝合输卵管两断端,用硬膜外穿刺针自患侧下腹壁穿刺腹壁将硬膜外导管远端引导至腹腔外,保留1周后拔除。疗效判定标准:下次月经干净后3~5 d行输卵管通液治疗1次,术后3个月复查碘油输卵管造影。结果 26例患者中1例术后第2个月发生宫内孕,另外29条输卵管治疗后26条输卵管再通,再通率为89.66%。26例均获一侧或双侧复通成功。结论留硬膜外导管支架在输卵管阻塞再通术对防止输卵管再粘连、吻合口疤痕收缩狭窄起重要作用,有效地提高了输卵管的再通成功率。
Objective To observe the effect of epidural catheter stents applied to the mid-distal tubal recanalization. Methods The head of epidural catheter was inserted into the anastomosis of fallopian tube from the end of oviduct, and then through the proximal lumen to the uterine cavity. Using this as a stent, the two ends of fallopian tube were stitched. The abdominal wall of the lower abdominal wall punctures the distal end of the epidural catheter to the outside of the abdominal cavity, and remains for 1 week after removal. Efficacy criteria: the next menstrual clean after 3 ~ 5 d tubal fluid treatment 1, 3 months after the review of iodized oil tubal angiography. Results One of the 26 patients had intrauterine pregnancy in the second month after operation. In addition, 26 tubal recanalization procedures were given after 29 tubal treatments, and the recanalization rate was 89.66%. Twenty-six patients were successful on one or both sides of the compound. Conclusions Epidural stent in tubal obstruction recanalization plays an important role in preventing tubal re-adhesion and anastomotic scar contraction and slippage, and effectively improves the success rate of fallopian tube recanalization.