| Objective: Under the guidance of ultrasound,the tubal obstruction was treated with ultra-slippery guide wire recanalization in interstitial catheter of hysteroscope,and the relationship among tubal patency rate,pregnancy rate and pregnancy time was compared and analyzed,so as to give corresponding guidance in clinical treatment.Methods: The infertility patients who visited the clinic of Reproductive Medicine Center of the Affiliated Hospital of Inner Mongolia University for Nationalities from September 2019 to September 2020 were collected.Under the guidance of ultrasound,hysteroscopic selective interstitial catheter drainage was placed.At the same time,75 patients with fallopian tube obstruction were diagnosed by abdominal ultrasound monitoring,resistance and macroscopic observation.The basic information was recorded,and they were divided into guide wire group and non-guide wire group according to the order of visits.38 cases in guide wire group were recanalized by ultra-slippery guide wire in interstitial catheter,37 cases in non-guide wire group were recanalized by interstitial catheter pressurization.All patients were given outpatient visits or telephone follow-up for12 months after operation and 3 months after pregnancy,and the results were recorded.Results:1.Comparison of general conditions between the guide wire group and the non-guide wire group: There was no significant difference in infertility age,infertility time,infertility type,tubal recanalization number and anti-Mü llerian hormone between the two groups(P > 0.05).2.Comparison of the number of fallopian tube recanalization after operation between guide wire group and non-guide wire group: in guide wire group,the total number of fallopian tube obstruction was 45 in 30 cases,24 in 30 cases(15 cases)with double obstruction+4 in 15 cases(15 cases)with single obstruction,and 1 in 11 cases with obstruction.After treatment,the total obstruction was 77.78%(35/45).Non-guide wire group: the total number of tubal obstruction in 30 cases was 39,and 18 cases(9 cases)were successfully obstructed after operation.There were 16 successful patency cases(21cases)and 3 patency cases.After treatment,the patency rate was 87.18%(34/39),3.7.69%(3/39),5.13%(2/39)and 94.87%(37/39).Compared with the non-guide-wire group,P > 0.05,and there was no significant difference.4.Comparison of postoperative pregnancy number between guide wire group and non-guide wire group: 30 cases in guide wire group and 16 cases in postoperative pregnancy;30 cases in non-guide wire group and 15 cases in post-operation pregnancy;The postoperative pregnancy rate of patients with guide wire group was 53.33%,and that of patients without guide wire group was 50.00%.Compared with those without guide wire group,the difference was not statistically significant(P > 0.05).4.Comparison of unilateral and bilateral recanalization treatment and pregnancy between the guide wire group and the non-guide wire group: in the guide wire group,there were 15 cases of double obstruction,30 cases of obstruction,28 cases of patency,the patency rate of 93.33%(28/30),10 cases of pregnancy,the pregnancy rate of66.67%(10/15),and 15 cases of single obstruction.Non-guide wire group: 9 cases with double resistance,18 blocked roots,18 unobstructed roots,100.00%(18/18)patency rate,6pregnant cases,66.67%(6/9)pregnancy rate,21 cases with single resistance,21 blocked roots,19 unobstructed roots,90.48% patency rate.There was no significant difference between the guide wire group and the non-guide wire group(P > 0.05).5.Comparison of postoperative secondary and primary infertility between wireguided group and non-wire-guided group: Wire-guided group: Among the 30 cases successfully followed up after operation,16 cases were pregnant,with a pregnancy rate of53.33%(16/30).19 cases were secondary infertility,12 cases were pregnant after operation,and the pregnancy rate was 63.16%(12/19).There were 11 cases of primary infertility and4 cases of pregnancy,with a pregnancy rate of 36.36%(4/11).Non-guidewire group:among the 30 cases successfully followed up after operation,15 cases were pregnant,and the pregnancy rate was 50.00%(15/30).There were 12 cases of secondary infertility,5cases of pregnancy,the pregnancy rate was 41.67%(5/12),18 cases of primary infertility,10 cases of pregnancy,the pregnancy rate was 55.56%(10/18).Compared with the nonguidewire group,the difference was not statistically significant(P > 0.05).6.Comparison of pregnancy months after operation between guide wire group and non-guide wire group: the pregnancy rates of 0 ～ 3 months,3 ～ 6 months,6 ～ 9 months and 9 ～ 12 months after operation in guide wire group were 30%,4.76%,10.00% and16.67% respectively,while those in non-guide wire group were 36.67%,15.79% and16.67% respectively.7.Comparison of pregnancy outcomes in 3 months after operation between guide wire group and non-guide wire group: 30 cases in guide wire group,2 cases in biochemical pregnancy,6.66% pregnancy rate,3 cases in abortion,10% in abortion rate,2 cases in ectopic pregnancy,6.66% in ectopic pregnancy,9 cases in 3 months pregnancy,30.00% in pregnancy rate.There were 30 cases in the non-guidewire group,1 case in biochemical pregnancy,3.33% in pregnancy rate,2 cases in abortion rate,6.67% in abortion rate,0 case in ectopic pregnancy,0% in ectopic pregnancy rate,12 cases in 3 months pregnancy,and40.00% in pregnancy rate.By comparison,there was no significant difference in biochemical pregnancy rate,abortion rate,ectopic pregnancy rate and three-month pregnancy rate(P > 0.05).Conclusion: There is no significant difference in tubal patency rate,pregnancy rate and 3-month pregnancy rate between hysteroscopic selective interstitial catheter recanalization with super-slippery guide wire and selective interstitial catheter recanalization with pressurized fluid.In guiding clinical work,it is suggested to choose the treatment of pressurized fluid resuscitation,which is relatively simple in operation,low in risk,and lower in economic burden than that of the guide wire group.It can be treated in grass-roots hospitals,and positive pregnancy occurs after pressurized fluid resuscitation,especially in the first three months after operation. |
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