- 患者告知书：输卵管手术后怀孕
- 作者：李诚|发布时间：2013-06-21|浏览量：2140次
资料来源：http://www.asrm.org顺德第一人民医院妇科古伟文岳阳市第一人民医院妇产科李诚
patient’s fact sheet 患者告知书
this fact sheet was developed in collaboration with the society of reproductive surgeons
这份告知书与生殖外科学会合作校订
the uterus (womb), where the fertilized egg develops into a fetus. fertilization, the process in which the man's sperm joins the egg, takes place in the fallopian tube. if your fallopian tubes are the reason of why you cannot get pregnant, your doctor may discuss surgery as an option to fix your tubes.
子宫是受精卵发育成胎儿的地方。受精是男性精子与卵子在输卵管结合的过程。如果输卵管是不孕的病因，医生会和你讨论选择手术修复输卵管。
what could damage my fallopian tubes? 什么情况会损伤输卵管？
infections, abdominal surgery, and other diseases, such as endometriosis, can cause scars to form between the end of the tube and the ovary. the tubes also can become damaged with adhesions or scar tissue inside the tube or can become completely blocked.
感染，腹部手术和其它疾病，例如子宫内膜异位症会导致输卵管末端和卵巢之间疤痕形成。输卵管也会因输卵管里面的粘连或疤痕组织而受损或完全闭塞。
the infections may be, but aren't always, sexually transmitted. two common sexually transmitted infections are chlamydia and gonorrhea. tuberculosis is very uncommon in north america, but it, too, can cause tubal disease. you can get a tubal infection after your appendix ruptures or bursts. surgery or endometriosis (lining of the uterus deposited in the lower part of the belly) can also damage your fallopian tubes.
感染不总是但可能是性传播的。两种常见的性传播感染是衣原体和支原体。在北美洲，结核不常见，但结核也能导致输卵管的疾病。阑尾炎破裂或穿孔后可导致输卵管感染。手术或子宫内膜异位症（盆腔的子宫内膜）也会导致输卵管损伤。
how can the damage be fixed? 损害怎样子修复？
the surgeon will try to cut the scars between your fallopian tube and ovary. if one or both tubes are completely blocked, your surgeon can attempt to open the tube.
手术将尝试切除输卵管和卵巢之间的疤痕。如果有一侧或两侧输卵管闭塞，医生可能尝试疏通输卵管。
before you have surgery, your doctor will check your tubes by x-ray (hysterosalpingogram) or by ultrasound (sonohysterogram) for damage and decide what kind of surgery you need. the doctor injects a special liquid into your womb and looks at the x-ray or ultrasound to see if the liquid travels all the way through the tube. if the liquid does not travel completely through the tubes, there may be blockage.
手术前，医生会用x线检查（子宫输卵管造影）或用b超检查（超声子宫造影）看损害的情况，决定要做的手术方式。医生将特别的药水灌注子宫然后用x线或b超看有没有液体通过输卵管。如果液体不能通过输卵管，可能就是闭塞了。
surgery can be done in one of two ways (laparoscopy or laparotomy). laparoscopy, or minimally invasive surgery, can be performed. during this procedure a very small camera attached to a thin telescope is inserted through a small incision (surgical opening) below your belly button. the surgery is performed using small tools, which can be inserted through other small incisions across your belly. a traditional open procedure, called a laparotomy, also may be used. in this procedure, the surgery is performed through a large incision made in your belly (abdomen).
手术可用一种或两种方式进行（腹腔镜或宫腔镜）。可以做腹腔镜即微创手术。在手术中一个很小的摄像头连着的小放大镜通过肚脐下小切口（手术刀口）插入。用一些能通过其他小切口进入腹腔的小器械做手术。也可以用传统手术开刀即剖腹手术，但要在腹部切开大切口。
will i be able to get pregnant? 我还能受孕吗？
if your tubes are not badly damaged, surgery might help you get pregnant naturally. your chance of getting pregnant after surgery is better if you are young and if the man has healthy sperm.
如果输卵管受损不太严重，手术有助于自然受孕。如果年轻或男性精子健康，手术后的怀孕机会更佳。
if your tubes are badly damaged, you might need infertility treatments to help you get pregnant. in vitro fertilization (ivf) is one treatment that is used. for ivf, your egg and the man's sperm are joined in the laboratory and then the doctor places the fertilized eggs into your womb. your doctor will need to decide if surgery or other treatment, such as ivf, is better for you.
如果输卵管受损严重，可能需要不孕治疗帮助受孕。体外受精（ivf）是一种有用的治疗，卵子和精子在实验室里结合，然后医生将受精卵放入子宫。医生要决定是不是手术或其它治疗例如体外受精适合你的情况。
what are the risks of tubal surgery? 输卵管手术有什么风险？
the biggest risk after tubal surgery is the possible development of a tubal (ectopic) pregnancy. a tubal pregnancy is a serious health problem that is more likely to happen after tubal surgery or tubal disease. the fertilized egg does not travel to the uterus. instead, it stays in the fallopian tube and begins to grow there. the tube is too small to hold a baby, and the tube will burst if the pregnancy continues. the mother may have internal bleeding or rarely could even die. therefore, if you have had tubal surgery or tubal disease, you should tell your doctor as soon as you think you are pregnant or have missed your period. irregular vaginal bleeding and lower abdominal pain are common symptoms associated with tubal pregnancy.
手术后最大的风险是发生输卵管妊娠（宫外孕）的可能。输卵管妊娠是更可能发生在输卵管手术或输卵管疾病后的严重健康问题。受精卵不能迁移到子宫，而是停留在输卵管开始发育。输卵管太小无法容纳胎儿。如果妊娠继续，输卵管就会破裂。导致内出血或甚至罕见的死亡。因此如果做了输卵管手术或患了输卵管疾病，应该在疑似受孕或月经周期延长时及早告诉医生。不规则阴道出血和下腹痛是输卵管妊娠的常见症状。
other risks include the possibility of bleeding, damage to other organs, or a reaction to the anesthesia.
其它危险包括出血，损伤其它器官或麻醉反应的可能。
if you have…
| your chance of getting pregnant after surgery is… |
very few adhesions between your tubes and ovaries | much better
|
lots of thick adhesions between your tubes and ovaries | not good, so you might need ivf
|
a blocked tube that is otherwise healthy | about 20% to 30%
|
a blocked tube that is filled with fluid (called hydrosalpinx) | not very good. ivf may work, but the tubes will need to be removed or surgically blocked to increase your chances of success |
如果出现… | 手术后受孕的机会是… |
输卵管和卵巢之间粘连很少 | 很大 |
输卵管和卵巢之间紧密粘连多 | 不好，可能要做体外受精 |
一侧输卵管闭塞，但还算好的 | 约20%到30% |
一侧输卵管里满是水（积水） | 很不好，可做体外受精，但要切除或结扎输卵管以提高成功率。 |
the american society for reproductive medicine grants permission to photocopy this fact sheet and distribute it to patients. created 2008
美国生殖医学会批准这份告知书复印件派发患者 2008年制订
