| Objective The purpose of this study is to evaluate the clinical application value of sodium hyaluronate combined with lipiodol and different antibiotics in the treatment of fallopian tube obstructive infertility.Materials and Methods With fallopian tube obstructive infertility patients were retrospectively analyzed in this study,a total of 440 cases,440 patients were randomly divided into 4 groups,respectively is metronidazole-iodized oil-sodium hyaluronate group(110 cases),metronidazole-sodium hyaluronate group(140 cases),metronidazole-iodized oil group(150 cases),levofloxacin-iodized oil group(40 cases).First three groups in interventional recanalization of fallopian tubes to postoperative tubal perfusion after metronidazole,respectively perfusing lipiodol-sodium hyaluronate,sodium hyaluronate,lipiodol,a fourth group is perfusied levofloxacin – lipiodol,each fallopian tube were injected metronidazole 20 ml,levofloxacin 20 ml,lipiodol 10 ml,sodium hyaluronate 15 ml.The patients were observed and recorded the site of each oviduct occlusion,the rate of intervention,and the pregnancy rate in 12 months.Results In this study,880 fallopian tubes were treated in 440 patients,and 880 tubes were diagnosed fallopian tube obstruction after the operation of HSG and SSG,and 806 tubes were successfully recanalizatized after the operation of FTR,and the recanalization rate was 91.6%(806/880).It was confirmed by SSG that there were 256 fallopian tubes interstitial obstruction,and the recanalization rate was 97.0 %(256/264).There were 108 fallopian tubes isthmus obstruction,and the recanalization rate was 94.7%(108/114).The recanalization rate was 92.7%(179/193)(P<0.05).There was a statistical significance in the differences in the number of obstruction position.The complication was only a small amount of vaginal bleeding,abdominal pain etc.The pregnancy rates of the three groups of anti-adhesion tubal intervention after recanalization were: the metronidazole-lipiodol-sodium hyaluronate group,48 cases of pregnancy,pregnancy rate was 43.6%(48/110);the metronidazole-sodium hyaluronate group,50 cases of pregnancy,,the pregnancy rate was 35.7%(50/140);the metronidazole-lipiodol group,37 cases of pregnancy,and the pregnancy rate was 24.7%(37/150).The differences in the three groups of pregnancy rates difference was statistically significant.(2=3.893,P<0.05.Chi-square = 15.322,P < 0.05.Chi-square = 4.209,P < 0.05).Two groups of different antibiotics were followed up for 12 months after the tubal intervention,and 37 cases of metronidazole-lipiodol group were pregnant,with a pregnancy rate of 24.7%(37/150).The pregnancy rate was 22.5%(9/40)of levofloxacin-lipiodol group.There was no significant statistical difference between the two groups of pregnancy rate differences.The difference was not significant statistical difference(chi 2=0.016,P> 0.05).In this study,in 440 cases of infertility caused by tubal obstruction,144 successful pregnancies were performed within 12 months after the prcedure of SSG and FTR,including 2 cases of ectopic pregnancy,1 case of stillbirth,and the remaining healthy infants.Among the 144 successful pregnancies,59.0%(85/144 cases)were pregnant within 4 months,and 24.3%(35/144 cases)of pregnancy in 5-8 months,and 16.7%(24/144 cases)of pregnancy in 9-12 months.There was significant statistical difference(P<0.05)in the three periods of pregnancy.There was no statistically significant difference in age and duration of infertility among the groups(P>0.05)).Conclusion The lipiodol combined with sodium hyaluronate can effectively improve the pregnancy rate of infertility caused by obstruction of the fallopian tube,which is better than the single use of sodium hyaluronate or lipiodol.The two anti-adhesive substances are combined with a good consistency and synergy;there was no difference in efficacy of levofloxacin and metronidazole for tubal inflammation;within 12 months after SSG and FTR,the shorter the postoperative time,the higher the pregnancy rate. |
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