腹腔镜在不孕症盆腔疾病诊治中的应用（附340例分析）

Application of Laparoscopy for Diagnosis and Treatment of Pelvic Diseases in Sterility

本文通过对南京市鼓楼医院腹腔镜下诊治不孕症３４０例的病例分析，阐明１．引起不孕症的主要盆腔疾病是慢性盆腔炎性疾病和子宫内膜异位症；２．腹腔镜下美蓝输卵管通液结果与术前子宫输卵管造影术和酚红输卵管通液术的结果差别极其显著（Ｐ＜０．０１），通畅组符合率分别为９０．２％和７９％，不通畅组不符合率分别为５０．５％和５９％；３．腹腔镜下９７．６％的疾病得到明确诊断，５３．２％施行了１４种不同手术，１２．９％经剖腹做了盆腔手术，５８．５％与宫腔镜联合应用，２６例在腹腔镜监护下做了子宫纵膈切开术和宫腔粘连分离术。

In this paper,340 patients with primary and secondary sterility diagnosed and treated with laparoscopy were analyzed. It was found that: (1) Most of the pelvic diseases of sterility were chronic PID and endometriosis, 74% in primary sterility group and 81% in secondary sterility group. (2) Comparing the result of tubal instillation with mrthylene blue under laparoscopy with that of hysterogra phy (HSG) and bubal instillation with phenolpthalein (PSP) beforo the laparoscopy,thero existed significant difference. (3)The eavesed of sterility wore verified by laparoscopy in 97. 6% of the cases. As a result, 53% (181/340) of the cases was performed with 14 kinds of operations under laparoscopy, 12.9% (44/340) was performed with laparostomy. Two hundred cases (58. 8%) were managed with laparoscopy and hysteroscopy revealing pathology of uterine cavity in 32 cases (16%). Intrauterine division of uterine septum or uterine adhesion under monitoring of laparoscopy was performed in 26 cases.