{"paper_id":"c77f690c-dde5-4400-916d-5ccb7ef5e785","body_text":"The curative effect of fallopian tube interventional recanalization \nand ethiodode oil \nBin He, Yamin Li, Jihong Hu, Wei Zhao  \nThe First Affiliated Hospital of Kunming Medical University, Kunming 650031, China \nAbstract. Objective: To analyze the efficacy of fallopian tube interventi onal recanalization and ethiodized \noil in treating fallopian tube obstruction. Methods: 84 patient s were selected from August 2020 to August \n2021. Patients were randomly divided into control group and obs ervation group, with 42 patients in each \ngroup. The control group was treated by conventional uterine la paroscopic combined surgery, and the \nobservation group adopted the method of tubal interventional re canalization combined with ethiodized oil. \nTo compare the treatment effect of the two groups, the serum inflammatory factor levels before and after the \ntreatment, and the postoperative recovery. Results: In terms of treatment effect, the to tal response rate was \n95.24% higher than 71.43% in the control group, and P <0.05. In terms of serum inflammatory factor levels, \nthere was no significant difference between the two groups befo re treatment, with P> 0.05; and IL-6 \n(64.02±12.52)ng/L, TNF-α (21.03±2.20) ng/L, respectively, lower than the control group (72.35±16.39) ng/L, \n(28.35±2.34)ng/L,P<0.05. In terms of postoperative recovery, the observation group had a postoperative pain \nscore (2.02±0.41) Break up and get out of bed activity time (16 .31±2.82) h, length of stay (2.31±0.82) d, \nlower than the control group (4.56±1.42) component, (24.42±5.47 )h, (4.42±0.47) d, P<0.05. Conclusion: In \nthe treatment of fallopian tube obstruction, the treatment meth od of fallopian tube interventional \nrecanalization combined with ethylene iodized oil can improve t he overall treatment e fficiency, reduce the \ninflammation, improve the postoperative recovery, and the curative effect is more ideal. \nKey words: Tubal interventional recanalization; ethylene iodine oil; tubal obstruction; efficacy. \nIn gynecological diseases, fallopian tube obstruction is a \nrelatively common disease, but also is one of the \nimportant causes of infertility [ 1]. The occurrence of the \ndisease is usually caused by the genital tract infection, \ncausing inflammation of the internal genital organs. \nGenerally after reproductive tract surgery, abortion, it is \neasy to be secondary to this disease, causing fallopian tube \nobstruction, and then cause infertility. At present, the \nincidence of the disease is relatively high, which has \ncaused a serious impact on female individuals and their \nfamilies[2]. In the past, although the surgical method \ncombining hysteroscopy and laparoscopy can play a \ncertain role, but the overall effect is not ideal, and it is \ndifficult to effectively control the inflammatory response. \nWith the development of interventional therapy \ntechnology, it can be used in fallopian tube obstruction, \nwhich can also be effective in inflammation control[3]. \nBased on this, 84 patients were selected from August 2020 \nto August 2021 to analyze th e efficacy of fallopian tube \ninterventional recanalization and ethiodized oil in the \ntreatment of tubal obstruction. \n \n \n \n1. Data and methods \n1.1 General Information \nEighty-four patients with tubal obstruction, selected from \nAugust 2020 to August 2021, were randomly divided into \ncontrol and observation groups of 42 patients in each \ngroup. In the control group, patients were 23 and 35 years, \nmean (28.46 ± 3.15), minimum, 1,8 years, mean (4.22 ± \n1.05) years; in the observation group, 24,36 years, mean \n(28.51 ± 3.07), 2 and 9 years, average (4.31 ± 1.02) years. \nIn the above indicators, the two groups were compared, \nwith no significant difference, and P> 0.05. \n Inclusion criteria: All met the diagnostic criteria for tubal \nobstruction, all showed infertility, all met the indications \nfor surgery and anesthesia, the study was informed to the \npatient and his family, and was approved by the Medical \nEthics Committee. \nExclusion criteria: patients with other serious \ngynecological diseases, patients with infectious diseases, \npatients with autoimmune deficiency diseases, and \npatients with contraindications to surgical anesthesia or \ninterventional treatment. \nhttps://doi.org/10.1051/bioconf/20236101022, 01022 (2023)BIO Web of Conferences 61\nFBSE 2023\n   © The Authors, published by EDP Sciences. This is an open access article distributed under the terms of  the Creative Commons Attribution License 4.0\n (http ://creativecommons.org/licenses/by/4.0/). s\n\n \n1.2 Methods \n1.2.1 The control group \nThe control group was treated by conventional uterine \nlaparoscopic combined surgery. At 2-3 days after clean \nmenstruation, tupingplasty was performed to treat the \ncomorbidities. For distal tubal blockage, intrauterine \nlaparoscopic intubation and dredging of the fallopian tube \nwere performed. With hysteroscopic assistance, a hard \ncatheter was implanted into the tubal opening, and a \nprearranged blue blue solution was injected into the hard \ncatheter lumen during continuous propulsion. Dextran, \ngentamicin, dexamethasone, and chymotrypsin were \nroutinely injected into the pelvis to prevent postoperative \npelvic adhesions. After surgery, the conventional \ntreatment of promoting blood circulation, removing blood \nstasis and anti-inflammation was taken. \n1.2.2 Observation group \nThe observation group took the fallopian tube \ninterventional recanalizatio n combined with ethylene \niodized oil. At 3-7 days after clean menstruation, routine \nblood test routine, and iodine allergy test, elective surgery. \nThe patient took the lithotomy position and lay supine on \nthe radiation bed. After gynecological examination, a \nDBH-double balloon tube was inserted into the uterine \ncavity. The contrast agent was  injected, and the uterine \ncavity was filled. It then slides into the 0.0535 I n \nguidewire. After reaching the position, the guidewire was \nremoved and the contrast agent was injected through the \ncatheter. Patients who remain blocked after selective \nsalpingography will then use a 3F catheter, a 0.015In \nguide wire, delivered to the tubal along a 5F catheter, and \nsalpingalization using a 0.015In guide wire. After surgery, \n20ml of normal saline, 80,000 u of gentamicin, \ndexamethasone 4mg, and 5mg of chymotrypsin were used \nfor intrauterine injection. Finally, 10ml of ethylene iodine \noil was used and injected in the uterine cavity and \nfallopian tube. \n1.3 Evaluation indicators \nT o  c o m p a r e  t h e  t r e a t m e n t  e f f e c t  o f  t h e  t w o  g r o u p s ,  t h e  \nserum inflammatory factor levels before and after the \ntreatment, and the postoperative recovery. The evaluation \ncriteria of treatment effect are: obvious effect: one year \nafter treatment, the bilateral fallopian tubes are \nunobstructed, and the adverse symptoms and signs \ndisappear; effective: one y ear after treatment, the \nfallopian tube is partially unblocked but not completely \nunblocked, and the adverse symptoms and signs are \nsignificantly relieved; ineffective: one year after treatment, \nthere is still fallopian tube blockage or obvious \ninflammatory reaction. The evaluation indexes of serum \nfactor levels included IL-6, TNF- α. Evaluation indicators \nof postoperative recovery include postoperative pain \nscore, time of ambulation, and length of hospital stay, in \nwhich postoperative pain was measured on the VAS scale, \nand higher scores indicated stronger pain. \n1.4 Statistical treatment \nData is processed by SPSS20.0 software to represent \ncount and measurement data  respectively in terms of \nnumber or rate, average and mean ± standard deviation, \nand use x2, t tested separately, as P <0.05, representing a \nsignificant difference. \n2. Results \n2.1 Comparison of the two groups in terms of \ntreatment effect \nIn terms of the treatment effect, the total response rate in \nthe observation group was 95.24% higher than the 71.43% \nin the control group, with P <0.05. \nTable 1. Comparison between the two groups in terms of treatment effect [n (%)] \ngroup Exam ple number excellence vali d of no avail Total effective \nobservation group 42 18 (42.86) 2 2 (52.38) 2 (4.76) 4 0 (95.24) \ncontrol group 42 13(30.95) 17(40.48) 12(28.57) 30(71.43) \nx2  0.818 0.766 6.943 6.943 \nP  0.366 0.382 0.008 0.008 \n2.2 Comparison between the two groups in \nterms of serum factor levels \nIn terms of serum inflammatory factors level, there was \nno significant difference between the two groups before \ntreatment, with P> 0.05; and IL-6 (64.02±12.52)ng/L, \nTNF-α(21.03±2.20) ng/L, respectively, lower than the \ncontrol group (72.35±16.39)ng/L, (28.35±2.34)ng/L, P＜\n0.05. \n \n \n \n \n \nhttps://doi.org/10.1051/bioconf/20236101022, 01022 (2023)BIO Web of Conferences 61\nFBSE 2023\n2\n\n \nTable 2. Comparison between the two groups in terms of serum factor levels (± s) x  \ngroup Example \nnumber \nIL-6(ng/L) TNF-α(ng/L) \npretherapy post-treatment pretherapy post-treatment \nobservation group 42 76.52±24.23 64.02±12.52  32.21±3.45 21.03±2.20 \ncontrol group 42 76.47±24.32 72. 35±16.39 32.24±3.30 28.35±2.34 \nt  0.009 2.617 0.041 14.770 \nP  0.992 0.011 0.968 0.000 \n2.3 Comparison between the two groups \nregarding the postoperative recovery status \nIn terms of postoperative recovery, the observation group \nhad a postoperative pain score (2.02±0.41) Break up and \nget out of bed activity time (16.31±2.82)h, length of stay \n(2.31±0.82) d, lower than the control group (4.56±1.42) \ncomponent, (24.42±5.47)h, (4.42±0.47)d, P＜0.05. \n \nTable 3. Comparison of the two groups on postoperative recovery (± s) x  \ngroup Example number Postoperative pain \n(points) Activity time (h) length of stay (d) \nobservation group 42 2.02±0.41 16.31±2.82 2.31±0.82 \ncontrol group 42 4.56±1.42 24.42±5.47 4.42±0.47 \nt  11.137 8.540 14.468 \nP  0.000 0.000 0.000 \n3. Discussion \n In today's society, the incidence of various sexual \ndiseases has gradually increased, and the rate of medical \nabortion and induced abortion has also increased. \nTherefore, the incidence of tubal obstruction has also \nincreased, and has become an important cause of female \ninfertility[4]. In the treatment of this disease, the use of \nfallopian tube interventional recanalization can achieve \nvery good results. This technique integrates the traditional \nuterosalpingography and the modern radiation \nintervention technology, using the mechanical motion of \nthe guide wire to release and separate the lumen of the \ntubal tube where the adhesion occurs [5]. At the same time, \nafter the microcatheter direct drug injection treatment, the \neffect is better than the traditional rectal and intrauterine \ndrug administration [6]. \n The use of fallopian tube interventional recanalization \ncombined with ethiodooil can improve the overall \nefficiency of treatment, and also help to increase the \nsuccess rate of treatment [ 7]. Mainly because ethyl \niodized oil has a low oil viscosity, it is easier to advance \nin the circuitous and small tubal lumen, which can make \nthe inner membrane surface of the fallopian tube just \nthrough the guide wire separation to maintain lubrication, \nto avoid the occurrence of readhesion. At the same time, \nthe fallopian tube can promote the cilium movement, so \nthat it recovers smooth, improve the function of egg \ndelivery, so that patients can restore the normal \nconception ability[8]. Therefore, this method has a high \nclinical application and promotion value. \nIn conclusion, in the treatment of fallopian tube \nobstruction, the treatment method of fallopian tube \ninterventional recanalizatio n combined with ethylene \niodized oil can improve the overall treatment efficiency, \nreduce the inflammatory response, improve the \npostoperative recovery, and th e curative effect is more \nideal. \nReferences \n1. Tan Yiqing, Lei Wenfeng, Zheng Shilin, et al. \nAnalysis of the effect of interventional tubal ozone \nrecanalization combin ed with microcoil for \nhydroplastic tubal interventional plug plug [J]. \nJournal of Practical Radiology, 2020,36 (1): 185-188. \n2. Luan Caixia, Zou Baolin, Xu Le, et al. Application of \ninterventional salvibal recanalization combined with \nIUI in couples with tubal obstruction combined with \nmale semen abnormalities [J]. Heilongjiang \nMedicine, 2020,33 (1): 173-175. \n3. Dai Shoufang, Dai Fangfang, Zhang Lixiao, et al. \nStudy on the clinical effect of fallopian recanalization \ncombined with Chinese medicine and physical \ntherapy for obstructive infertility [J]. Chinese Journal \nof Modern Medicine, 2021,31 (15): 162-163. \n4. Lu Hai, Du Wei, Zhou Zhou, et al. Application of \nsuperslip microguidewire penetration in \ninterventional recanalizatio n for tubal obstructive \ninfertility [J]. Imaging Research and Medical \nApplication, 2019,3 (10): 158-160. \n5. Liu Jing, Wang Jing, Qu Hongwei, et al. Clinical \nstudy on the treatment of obstructive tubal \nobstructive infertility [J]. International Journal of \nTraditional Chinese Medicine, 2018,40 (9): 134-137. \n6. Liao Jianmei, Zhang Qiang, Yu Jie. The effect of \ntraditional Chinese medicine enema and oral \nhttps://doi.org/10.1051/bioconf/20236101022, 01022 (2023)BIO Web of Conferences 61\nFBSE 2023\n3\n\n \ncombined fallopian tube interventional recanalization \nin treating hot and humid stasis fallopian tube \nobstructive infertility observation [J]. Chinese Sex \nScience, 2021,30 (9): 122-124. \n7. Liu Wei, Yu Min, Ran Shirong, et al. Efficacy of \nTCM warm renal pass collaterals method combined \nwith interventional recanalization for tubal \nobstructive infertility [J]. The Journal of Practical \nTraditional Chinese Medicine, 2020,36 (10): 123-125. \n8. Li Juan, Wang Jialu, Xie Tingting. Analysis of the \neffect of interventional recanalization on salpingbal \nobstructive infertility and re lated factors affecting \npostoperative pregnancy rate [J]. PLA Medical \nJournal, 2021,33 (8): 92-95. \nhttps://doi.org/10.1051/bioconf/20236101022, 01022 (2023)BIO Web of Conferences 61\nFBSE 2023\n4","source_license":"CC0","license_restricted":false}