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急性盆腔炎引起输卵管阻塞的预防研究

王芳   

  1. 天津医科大学第二医院
  • 收稿日期:2011-04-18 修回日期:2011-05-22 出版日期:2011-11-15 发布日期:2011-11-15
  • 通讯作者: 王芳

Study on Therapeutic Effect in Preventing Tubal Obstruction after Pelvic Inflammatory Disease

  • Received:2011-04-18 Revised:2011-05-22 Published:2011-11-15 Online:2011-11-15

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摘要： 目的：探讨急性盆腔炎（PID）治愈后应用防粘连剂行输卵管通液术预防输卵管粘连的治疗效果。方法：取急性PID患者宫颈阴道分泌物，进行病原体检测及培养，给予抗生素治疗，将痊愈患者随机分为研究组（n=30）、对照组(n=30)。于月经后研究组使用常规药液+透明质酸钠输卵管通液治疗两次，术中观察输卵管通畅程度，对照组无治疗；术后1个月随访两组均行输卵管常规药液通液术比较输卵管通畅率。结果：（1）PID患者宫颈分泌物培养检测出的主要病原体为大肠埃希氏杆菌、表皮葡萄球菌、人型支原体（MH）、衣原体（CT），混合感染率可达64.8%。且合并细菌性阴道病（BV）感染达54.9%。（2）研究组第一次通液时输卵管通畅率为53.3%、治疗1月后复查通畅率显著升高达83.3%，具有统计学差异(P<0.05)；治疗后输卵管通畅率研究组（83.3%）与对照组（53.3%）相比有显著增加，具有统计学差异(P<0.05)。结论：1) PID感染的主要病原体多为混合感染；2) 在抗炎治愈基础上给予输卵管防粘连治疗可以减少PID治疗后输卵管粘连的发生。

关键词: 急性盆腔炎, 病原体, 输卵管通液术, 透明质酸钠

Abstract: Objective：To study the efficacy of anti-adhesion agent used in preventing tubal obstruction after acute Pelvic Inflammatory Disease(PID)．Methods：The cervical and vaginal secretions of the patients with acute PID were collected for bacteria culture and test. All the patients received broad spectrum antibiotics. The patients recovered from acute PID were randomly divided into two groups, study group（n=30）and control group(n=30). The patients in the study group were given hydrotubation with regular drug and sodium hyaluronate for two times after menstrual period. The patients in each group were followed up on tubal patency exam after 1 month. Results：(1) In the PID patients the major etiological agents were eolibacillus, staphylococcus epidermidis, mycoplasma huminis (MH) and chlamydia trachomatis (CT). The combined infection rate was 64.8%，and 54.9% patients were concurrent infected with bacterial vaginosis(BV). (2) The tubal patency rate of study group after 1 month of treatment with sodium hyaluronate was 83.3%，which was significantly higher than 53.3% before treatment(P<0.05). After 1 month the tubal patency rate of study group treated with sodium hyaluronate was 83.3% which was significantly higher than 53.3% in the control group with statistical difference(P<0.05). Conclusions：(1)The etiological agents of PID always were combined infection. (2) Anti-adhesion agent could be effective to prevent tubal obstruction after PID．

Key words: pelvic inflammatory disease, etiological agents, hydrotubation, sodium hyaluronate