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1 临床资料 本院自1985～1988年共做有支架输卵管吻合术72例,年龄25～39岁。绝育方式为潘氏改良法34、例,抽芯包埋法29例,伞端切除法5例,银夹法4例。复孕术距绝育术时间为2～6年。2 手术方法 术前常规应用抗生素3天,阴道擦洗3天。采用硬膜外麻醉,取下腹正中切口,用输卵管吊钩将输卵管吊出腹腔,在输卵管浆膜下注入生理盐水,纵形切开输卵管浆膜层,游离结扎处两端的输卵管,切除瘢痕及阻塞部位,暴露管腔,将尼龙线由伞端开始向管腔穿入通过输卵管间质部进入宫腔,然后用6-0无损伤缝针,以显微外科器械,将输卵管断端缝合4～6针,间断缝合输卵管浆膜层,将尼龙支架超出伞部2cm,用0号丝线缝扎固定在伞端,以免支架滑出;于月经来潮后从宫腔将尼龙支架取出。术中用含肝素的生理盐水冲洗术野,以吸引器吸出渗液,勿用纱布擦拭,以免组织粗糙造成术后粘连。术后再用抗生素一周。术后共随访60例,复孕51例。
1 Clinical data Hospital from 1985 to 1988 a total of 72 cases of stent-tubal anastomosis, aged 25 to 39 years old. Sterilization methods for Pan’s improved method 34, for example, withdrawing core embedding 29 cases, umbrella end resection in 5 cases, silver folder in 4 cases. Pregnancy from sterilization time of 2 to 6 years. 2 surgical methods preoperative routine antibiotics 3 days, vaginal scrub 3 days. Epidural anesthesia was used to remove the median incision of the abdomen. The tubal was removed from the abdominal cavity with the hook of the fallopian tube. Salivary tubal was injected with saline into the fallopian tube. The salpingo-tubal incision was longitudinally cut. Parts of the exposed lumen, the nylon line from the umbrella end to the lumen through the tubal interstitial into the uterine cavity, and then with 6-0 non-destructive needle to microsurgical instruments, the fallopian tube suture 4 ~ 6-pin, intermittent suture tubal serosal layer, the nylon stent beyond the umbrella 2cm, No. 0 suture fixed in the umbrella end, so as not to slide out; in the menstrual cramps will be removed from the uterine cavity stent. Intraoperative use of heparin-containing saline flush surgical field, aspirated suction exudate, do not use gauze to wipe, so as to avoid rough tissue caused by postoperative adhesions. Re-use of antibiotics after a week. A total of 60 cases were followed up and 51 cases were re-conceived.