腹腔镜诊治女性不孕症516例临床分析

Laparoscopy in the diagnosis and treatment of 516 women with infertility

目的 :探讨腹腔镜在女性不孕症诊断及治疗中的价值。方法 :对 5 16例女性不孕症患者腹腔镜手术检查及治疗的资料进行回顾性分析。结果 :4 88例 (94 .5 7% )腹腔镜检查发现盆腔病变 ,其中盆腔单一疾患者 393例 (占 80 .5 3% ) ,合并两种以上者95例 (19.4 7% ) ,84例 (16 .2 8% )腹腔镜手术诊断与术前临床诊断不一致。盆腔黏连、慢性输卵管炎和子宫内膜异位症是造成女性不孕的主要病因。盆腔黏连松解术、输卵管通液术、输卵管造口术、子宫内膜异位病灶去除术、卵巢囊肿剥除术、多囊卵巢电凝打孔术为腹腔镜主要治疗术式。术后随访到 30 9例 ,随访率 5 9.88% ,自然宫内妊娠 6 7例 (32 .5 2 % ) ,其中 4 9例(73.14 % )的妊娠发生在术后 1年之内。结论 :腹腔镜技术可以明确绝大部分不孕症的病因并进行相应处理 ,对不孕症的诊断和治疗具有重要价值。

Objective:To evaluate the laparoscopy in the diagnosis a nd treatment of female infertility.Methods: 516 infer tile women who had undergo ne laparoscopic surgery were analyzed retrospectively. Results: 488 (94.57%)c ases had positive results following laparoscopy. 393 cases(80.53%)were diagno sed as single pelvic disease, and 95(19.47%)cases had more than one disease. In 84(16.28%)cases, pelvic diseases had been misdiagnosed or missed before la paroscopy. Pelvic adhesions and chronic inflammatory disease of oviduct and e ndom etriosis were major causes of infertility. Lysis of pelvic adhesions, hydrotubat ion monitored by laparoscopy, dilation of fallopian, salpingostomy, resection of endometriotic lesions, myomectomy and insulated needle cautery of polycystic ov aries were the major treatment methods. 309 (59.88%) patients were followed up for 1 to 6 years after laproscopic surgery. 36.73% patients got normal pregnanc y (73.14% got it within 12 months) after operation.Concl usion:Laparos copic technology is significantly effective in the diagnosis and treatment of fe male infertility.