摘要：
Objective To study the curative effect and dose-effect relationship of combined chitosan and danshen injection used in preventing tubal obstruction after recanalization.Methods 320 patients with fallopian tube obstruction infertility were randomly assigned to four groups.Group A (the control group),group B (including Chitosan 2 ml,Danshen 4 ml),group C (include Chitosan 2 ml,Danshen 10 ml),D group (including Chitosan 1 ml,Danshen 10 ml).The control group underwent recanalization with anti-inflammation agents alone.While,other groups were injected with the different proportion of combined chitosan and danshen injection after recanalization.The rate of tubal recanalization,complication incidence rate were recorded during operation.Then patients in every group were followed up on tubal patency rate after 3 months,tubal patency rate and pregnancy rate after 12 months.Results 1) The recanalization rate were 94.1％ in group A,95.7％ in group B,97.8％ in group C,96.4％ in group D,which did not show statistical difference (P ＞ 0.05);2) The complication incidence rate of group B,group C,group D were significantly higher than it in group A (x2 =9.06,P ＜ 0.01);3) The rates of tubal patency after 3 months of 93.0％ in group C were significantly higher than it in group A (66.9％),group B (82.9％),group D (82.6％) (P ＜ 0.05);4) The recanalization rate after 12 months were (94.3％) in group C were significantly higher than it in group A (44.6％),group B (77.8％),group D (74.2％) (P ＜ 0.05);5) The rates intrauterine pregnancy after 12 months were 56.3％ in group C were significantly higher than that in group A (30％),group B (43.8％),group D (42.5％) (P ＜0.05).Conclusion Combined chitosan and danshen injection could be effective to prevent tubal obstruction after interventional recanalization and increase pregnancy rate.Appropriate concentration of combined chitosan and danshen injection should be better than the others.It will be unique for fallopian tube obstruction by interventional recanalization.%目的 探讨在输卵管介入治疗再通术中应用几丁糖丹参混合液的临床价值及量效关系.方法将320例输卵管阻塞患者随机分为A组(对照组)、B组(几丁糖2ml,丹参注射液4ml)、C组(几丁糖2ml,丹参注射液10ml)、D组(几丁糖1ml,丹参注射液10ml).A组在输卵管复通术后,在输卵管腔内只灌注松解液作消炎治疗.在A组基础上,B组、C组、D组分别再灌注不同配比几丁糖丹参混合液.术中观察介入治疗复通率,并发症发生率.术后3个月输卵管通水通畅率,术后12个月输卵管复通率及随访妊娠率.结果 1)术后介入治疗复通率:A组、B组、C组及D组分别为94.1％,95.7％,97.8％和96.4％,差别无统计学意义(P＞0.05);2)B组、C组、D组并发症发生率显著低于对照组(x2=9.06,P＜0.01);3)术后3个月输卵管通水通畅率:C组(93.0％)明显高于A组(66.9％)、B组(82.9％)、D组(82.6％),差异有统计学意义(P＜0.05);4)复通术后12个月输卵管通畅率:C组(94.3％)明显高于A组(44.6％)、B组(77.8％)、D组(74.2％),差异有统计学意义(P＜0.05);5)术后12个月内妊娠率C组(56.3％)高于A组(30％)、B组(43.8％)、D组(42.5％),差异也有统计学意义(P＜0.05).结论 几丁糖丹参混合液能有效地减少输卵管介入治疗再通术后输卵管再粘连的发生,提高妊娠率.几丁糖与丹参混合浓度适中治疗效果最佳,在介入治疗再通术中应用有其独特的优势.
