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Fallopian Tube Procedures for Infertility 输卵管不孕治疗 A fallopian tube blockage typically prevents successful passage of the egg to the sperm, or the fertilized egg to the uterus. Surgery can be used to try to correct this common cause of infertility. The specific type of surgery depends on the location and extent of the fallopian tube blockage. 输卵管堵塞会防止精子与卵子的结合，或阻碍受精卵进入子宫。手术可以纠正这一常见病变。这种特殊的手术直接作用于阻塞的病变部位。 Some tubal procedures can be done using microsurgical techniques, either during open abdominal surgery or using laparoscopy through a small incision. The surgeon must have special training and expertise in microsurgery techniques and/or laparoscopy. This general overview describes the most common tubal procedures. 一些输卵管病变可以通过手术治疗，要么开腹要么通过小切口的腹腔镜治疗。这种手术必须在微创手术方面或腹腔镜手术方面经过特殊训练、专业的人进行。 Tubal reanastomosis typically is used to reverse a tubal ligation or to repair a portion of the fallopian tube damaged by disease. The blocked or diseased portion of the tube is removed, and the two healthy ends of the tube are then joined. This procedure usually is done through an abdominal incision (laparotomy), but some specialists can do this procedure using laparoscopy. 输卵管吻合术主要用来解除输卵管结扎或修复输卵管部分病变。闭锁或病变的部分被治愈，形成两个完好的输卵管。这种治疗通常通过开腹手术，有些专家可通过腹腔镜手术治疗。 Salpingectomy, or removal of part of a fallopian tube, is done to improve in vitro fertilization (IVF) success when a tube has developed a buildup of fluid (hydrosalpinx). Hydrosalpinx makes it half as likely that an IVF procedure will succeed.1 Salpingectomy is preferred over salpingostomy for treating a hydrosalpinx before IVF. 输卵管切除术或者切除部分输卵管可提高输卵管积水患者试管婴儿的成功率。输卵管积水会降低试管婴儿的成功率。在做试管婴儿之前切除积水的输卵管成功率更高。 Salpingostomy is done when the end of the fallopian tube is blocked by a buildup of fluid (hydrosalpinx). This procedure creates a new opening in the part of the tube closest to the ovary. But it is common for scar tissue to regrow after a salpingostomy, reblocking the tube. 输卵管造口术适合输卵管伞端闭锁的病人。这种治疗可再次打开输卵管，但通常会产生疤痕组织，再次堵塞输卵管。 Fimbrioplasty may be done when the part of the tube closest to the ovary is partially blocked or has scar tissue, preventing normal egg pickup. This procedure rebuilds the fringed ends of the fallopian tube. For a tubal blockage next to the uterus, a nonsurgical procedure called selective tubal cannulation is the first treatment of choice. Using fluoroscopy or hysteroscopy to guide the instruments, a doctor inserts a catheter, or cannula, through the cervix and the uterus and into the fallopian tube. 输卵管伞成形术适合输卵管闭锁并有疤痕组织的患者以防止正常拾卵。这种治疗方法重新建立的手指大小的输卵管。对于阻塞在子宫边的输卵管，一种非手术的治疗方法叫做选择性输卵管插管术，穿过子宫进入输卵管。 术后效果 After open abdominal surgery, there usually is a 2- to 3-day hospital stay. Antibiotics may be given to prevent infection. A woman usually can return to work in 4 to 6 weeks, depending on the extent of surgery, the nature of her work, and her overall health and stamina. After laparoscopic surgery, there is a brief hospital stay. A woman's return to daily activities can take a few days to a couple of weeks, depending on the type of procedure. 开腹手术后通常要在医院呆2-3天。抗生素治疗防止感染。女性4-6周后可回去工作，需依据手术情况，她的工作性质，她的健康状况和整体耐受能力。腹腔镜手术后可在医院少少观察。依据治疗方法不同，女性可几日或几周恢复日常生活。 Fallopian tube surgery may be done if:输卵管手术在以下情况做： Hysterosalpingography shows blocked fallopian tubes. A blocked fallopian tube has a buildup of fluid (hydrosalpinx). You want to have a tubal ligation reversed. 子宫输卵管造影术显示输卵管闭锁。输卵管闭锁并伴有积水。你想解除输卵管结扎术。 The success of a fallopian tube procedure depends in part on the location and extent of the blockage, as well as the presence or absence of other fertility problems. 成功的输卵管手术取决于手术的部位及闭锁的程度，以及其它的生育问题。 Clearing a blockage in the part of the tube closest to the uterus (proximal occlusion) is more likely to be successful. These blockages often are functional (such as a mucus plug) rather than structural (such as scarring or other obstruction). Up to 60 out of 100 women with proximal occlusion have been reported to have successful pregnancies after tubal surgery.2 清除接近子宫部位的阻塞（近端阻塞）更有可能成功。这种阻塞往往是功能性（黏液阻塞）的而不是结构性（疤痕不是其它）的。60%-100%妇女术后成功怀孕。 From 20 to 30 out of 100 women with a blockage near the end of the fallopian tube have had successful pregnancies after tubal surgery.2 The amount of fallopian tube that remains after surgery is critical to the function of the tube. If a large part of the tube must be removed to eliminate blockage, the likelihood of pregnancy after surgery is reduced. 有20%-30%的近端闭锁的妇女术后成功怀孕。术后保留输卵管多少及其功能性更为重要。如果大部分输卵管必须移除以减少阻塞，术后怀孕的可能性就会降低。 The success of a sterilization reversal is influenced by the tubal ligation method used, by how recently the tubal ligation was done, and by the woman's age-related fertility. 绝育手术回转的成功被输卵管结扎方法影响，取决于结扎的方法，以及妇女的生育年龄。 Other conditions that affect the success of surgery include not only whether the woman has scar tissue (adhesions) in her pelvis and whether she has other diseases in the pelvic area but also the surgeon's level of skill and experience. 其它条件影响手术成功包括妇女有疤痕组织（盆腔粘连），是否她有其它盆腔疾病，还有手术的技能以及经验。 Risks of fallopian tube surgery include:输卵管手术的风险包括： Pelvic infection.盆腔感染 Scar tissue (adhesions) forming on the reproductive organs, causing them to bind to the abdominal wall or to other organs. Increased risk of tubal (ectopic) pregnancy after surgery. 生殖器官疤痕组织粘连，导致他们粘在腹壁上或其它器官上。增加术后宫外孕风险。 Some fallopian tube problems can be treated with more than one type of surgery or procedure. Ask your doctor for his or her success rates (birth of a healthy baby), as well as national success rates, for any procedure you are considering. 一些输卵管问题需要多次手术。问问医生成功率多少（身体恢复健康），以及全面的成功率是多少。 Hysterosalpingography may be done 3 to 6 months after surgery, to check whether the tubes have been opened. 术后3-6个月进行子宫输卵管造影术以检查输卵管是否打开。 If you do not become pregnant within 12 to 18 months following surgery, your doctor may do a laparoscopy to check the condition of your fallopian tubes or may refer you for in vitro fertilization (IVF). 如果你术后12-18个月没有怀孕，你的医生会为你做个腹腔镜检查，检查你的输卵管情况，或者推荐你做试管婴儿。 When successful, a fallopian tube procedure can enable a woman to have more than one pregnancy without ongoing fertility treatment and repeated use of IVF. 如果手术成功，输卵管治疗后可使妇女怀孕不只一次，无需怀孕治疗或反复试管婴儿治疗。 |
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