输卵管妊娠手术患者生殖功能恢复的现代意义

Q4 Medicine

International Medical Journal Pub Date : 2020-12-24 DOI:10.37436/2308-5274-2020-4-8

M. Kozub

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引用次数: 0

摘要

输卵管妊娠的原因包括女性生殖器官的主要炎症性疾病，盆腔粘连，这是先前剖腹手术的结果。实验和临床研究的目的是提高晚期输卵管妊娠妇女生殖健康的有效性，并开发新的方法来改进其技术，包括内窥镜检查、抗粘连药物、胎盘冷冻提取液、理疗和辅助生殖技术。为了证明使用这些方法的合理性，在196只成年雌性Wistar大鼠和90只雌性BALB/C小鼠中进行了实验。分析了518名妇女的临床观察数据，这些妇女采用了不同的生殖功能治疗和康复方法。事实证明，在患者中使用链激酶和链激酶有助于将粘连的发生率降低1.6倍；聚环氧乙烷与羧甲基纤维素、链激酶与链激酶和胎盘冷冻提取液共2.2次；与术中检测到的粘连程度相比，透明质酸钠、链激酶与链激酶的链多糖酶和胎盘冷冻提取物使粘连程度增加了2.6倍。为了优化输卵管妊娠患者恢复生殖功能的方法，建议采用腹腔镜器官保留治疗，术中给予抗粘连药物以及联合物理治疗。在64.9-75.7%的病例中，将辅助生殖技术纳入未自然怀孕患者的上述两阶段治疗有助于子宫妊娠的发生，这与对照组的这一指标没有显著差异。关键词：输卵管妊娠，生殖功能，腹腔镜，输卵管切开术，无线电波能量，粘连过程，抗粘连屏障，物理治疗，卵巢早衰模型，胎盘冷冻提取液。

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MODERN ASPECTS OF REPRODUCTIVE FUNCTION RECOVERY IN PATIENTS UNDERWENT SURGERY FOR TUBAL PREGNANCY

Among the causes of tubal pregnancy are the main inflammatory diseases of female genital organs, presence of adhesions in the pelvis, which developed as a result of previous laparotomy. The purpose of experimental and clinical studies was to increase the effectiveness of reproductive health in women with advanced tubal pregnancy and to develop new approaches to improve its techniques using endoscopy, anti−adhesion drugs, placental cryoextract, physiotherapy and assisted reproductive technologies. To justify the use of these methods, an experiment was performed in 196 adult female Wistar rats and 90 female BALB / C mice. There were analyzed the data of clinical observations of 518 women for whom different methods of treatment and rehabilitation of reproductive function were used. It was proven that the use of streptodornase with streptokinase in the patients helped to reduce the incidence of adhesions by 1.6 times; polyethylene oxide with carboxymethyl cellulose, streptodornase with streptokinase and cryoextract of the placenta did in 2.2 times; sodium hyaluronate, streptodornase with streptokinase and cryoextract of the placenta increased it in 2.6 times compared with the intraoperatively detected degree of adhesion. To optimize the method of recovering reproductive function in the patients with tubal pregnancy, the use of laparoscopic organ−preserving treatment with intraoperative administration of anti−adhesive drugs as well as a combined physiotherapeutic treatment was advisable. The inclusion of assisted reproductive technologies in the above two−stage treatment of the patients who did not become pregnant naturally contributed to the onset of uterine pregnancy in 64.9−75.7 % of cases, which did not differ significantly from this index in the control group. Key words: tubal pregnancy, reproductive function, laparoscopy, tubotomy, radio wave energy, adhesion process, anti−adhesion barrier, physiotherapeutic treatment, model of premature ovarian failure, placental cryoextract.

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来源期刊

International Medical Journal 医学-医学：内科

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The International Medical Journal is intended to provide a multidisciplinary forum for the exchange of ideas and information among professionals concerned with medicine and related disciplines in the world. It is recognized that many other disciplines have an important contribution to make in furthering knowledge of the physical life and mental life and the Editors welcome relevant contributions from them. The Editors and Publishers wish to encourage a dialogue among the experts from different countries whose diverse cultures afford interesting and challenging alternatives to existing theories and practices. Priority will therefore be given to articles which are oriented to an international perspective. The journal will publish reviews of high quality on contemporary issues, significant clinical studies, and conceptual contributions, as well as serve in the rapid dissemination of important and relevant research findings. The International Medical Journal (IMJ) was first established in 1994.