To investigate the effect of prophylactic use of cefalexin combined with metronidazole on the pathogenesis of acute pelvic inflammatory disease after tubal angiography.

From January 2016 to December 2018, a total of 738 patients underwent hysterosalpingography in The Eighth Hospital Affiliated to Sun Yat-sen University. According to the principle of random number table, the patients were divided into preoperative prevention treatment group, postoperative prevention treatment group and control group, with 246 cases in each group. The patients in control group were given routine preparation for hysterosalpingography, while patients in preoperative and postoperative preventive treatment groups were given cefalexin and metronidazole. All the patients received routine hysterosalpingography. The incidence of acute pelvic inflammatory disease within 1 month after operation of three groups were compared.

The age (F = 2.149, P = 0.126), infertility years (F = 1.214, P = 0.305), number of abortions (F = 0.047, P = 0.954), menstrual disorder (χ² = 0.758, P = 0.684), history of endometriosis (χ² = 0.647, P = 0.724), history of ectopic pregnancy (χ² = 0.561, P = 0.756), history of pelvic inflammatory disease (χ² = 0.575, P = 0.750) and pelvic or accessory mass (χ² = 0.473, P = 0.789) were not significantly different among three groups. The incidence of acute pelvic inflammatory disease of preoperative prevention treatment group (1.63%) and postoperative prevention treatment group (2.03%) were both significantly lower than that of the control group (5.28%), with significant differences (χ² = 4.935, P = 0.026; χ² = 3.781, P = 0.049). For symptoms and signs, compared with control group, the incidence of fever [2 (0.81%) vs. 9 (3.66%): χ² = 4.556, P = 0.032; 3 (1.22%) vs. 9 (3.66%): χ² = 4.132, P = 0.044], vaginal bleeding [2 (0.81%) vs. 7 (2.85%): χ² = 4.016, P = 0.048; 1 (0.41%) vs. 7 (2.85%): χ² = 4.574, P = 0.032] and hydroponic effusion [1 (0.41%) vs. 8 (3.25%): χ² = 5.546, P = 0.019; 2 (0.81%) vs. 8 (3.25%): χ² = 3.774, P = 0.049] in preoperative prevention treatment group and postoperative prevention treatment group were significantly decreased, with significant differences.

Preoperative or postoperative prophylactic use of cefalexin combined with metronidazole could effectively reduce the incidence of acute pelvic inflammatory disease.