腹腔镜和宫腔镜在不孕症诊治中的应用

Application of laparoscopy and hysteroscopy in infertility.

本文对320例不孕症患者行腹腔镜检查,其中47例同时行宫腔镜检查及治疗。腹腔镜检查结果表明,盆腔炎症和子宫内膜异位症是本组病例中最常见的病因,占77.5％,由此引起的盆腔粘连和输卵管阻塞占71.33％,而这些病例56.9％(110/255)没有临床表现,因此腹腔镜检查是诊断盆腔炎和子宫内膜异位症的可靠方法。47例宫腔镜检查发现异常占21.3％,其中27例49条阻塞输卵管在宫腔镜下加压通液及行插管术,其中8例11条输卵管通畅,占29.6％,4例妊娠。因此对HSG或腹腔镜检查发现的输卵管阻塞,特别是近端阻塞,可在腹腔镜监视下,行宫腔镜加压通液或输卵管插管再通术以减少误诊。

Three hundred and twenty women with infertility underwent a laparoscopy; 47 of them underwent a hysteroscopy simultaneously, among whom, 27 women with obstructed tube underwent the hysteroscopie hydrotubation and cannulation. It was found that the pelvic inflammatory disease and endometriosis were the most common causes of infertility in our study,occuring in about 77% of the patients. Adhision and tubal occlusion occurred in 71% of those cases, but 60% of them did not produce and symptom or sign. The abnormality of uterine cavity was found in 21% of the patients. Eight of the 27 women had at least one patent tube. after hysteroscopic hydrotubation and cannulation, 4 of them became pregnant. Therefore, combination of laparoscopy with hysteroscopy ought to be an important procedure in the evaluation and treatment of infertility.