宫腹腔镜治疗输卵管堵塞的临床体会

Clinical Experience of Hysteroscopy and Laparoscopy in Treatment of Tubal Obstruction

目的探究宫腔镜+腹腔镜对输卵管堵塞治疗价值。方法选取广东省佛山市高明区人民医院在2018年1月至2019年12月期间收治86例输卵管堵塞患者,依据不同治疗方式分为A、B组,分别行腹腔镜、宫腔镜+腹腔镜治疗,比较两组手术及康复相关指标、应激反应情况、术后并发症发生率及半年输卵管疏通率、妊娠率。结果B组手术时间、术中出血量、术后导尿时间、排气时间、住院时间均与A组相近,差异无统计学意义(P>0.05);术前两组皮质醇及肾上腺素水平相近,差异无统计学意义(P>0.05),术后两组皮质醇及肾上腺素水平均较术前上升,差异有统计学意义(P<0.05),但两组之间比较差异无统计学意义(P>0.05);B组并发症发生率为11.63%,与A组9.30%相近,差异无统计学意义(P>0.05);B组半年输卵管通畅率及半年妊娠率分别为97.67%、83.72%,均较A组83.72%、32.56%高,差异有统计学意义(P<0.05)。结论在输卵管堵塞治疗中,与单纯性腹腔镜手术治疗相比,实施腹腔镜+宫腔镜治疗,可提升半年输卵管疏通率及妊娠率,同时未增加并发症发生率,对患者康复时间及应激反应无显著影响,治疗效果理想。

Objective To explore value of hysteroscopy and laparoscopy in treatment of tubal obstruction.Methods The paper chose 86 patients with fallopian tube obstruction in our hospital from January 2018 to December 2019,and divided them into group A and group B according to different treatment methods,with laparoscopy,hysteroscopy and laparoscopy respectively.Operation rehabilitation related indicators,stress response,incidence of postoperative complications,fallopian tube dredging rate and pregnancy rate were compared between two groups.Results Operation time,intraoperative blood loss,postoperative catheterization time,exhaust time and hospital stay of group B was similar to group A(P>0.05);levels of cortisol and epinephrine in two groups were similar before operation(P>0.05),but increased after operation(P<0.05),there was no statistical significance between two groups(P>0.05);complication incidence of group B was 11.63%,similar to group A(9.30%)(P>0.05);half year tubal patency rate and half year pregnancy rate in group B were 97.67%and 83.72%respectively,which were higher than 83.72%and 32.56%in group A(P<0.05).Conclusion In treatment of tubal obstruction,compared with simple laparoscopic surgery,laparoscopic+hysteroscopic treatment can improve tubal patency rate and pregnancy rate for half a year,with no increase of complications incidence,no significant effect on recovery time and stress response of patients,with ideal treatment effect.