腹腔镜子宫悬吊术治疗不孕症的临床研究

The clinical research of laparoscopic ventrifixation in the treatment of in fertility

目的:探讨腹腔镜子宫悬吊术治疗不孕症的临床效果.方法:2001年1月至2002年7月为不孕症合并子宫后倾后屈的10例患者施腹腔镜下子宫悬吊术.结果:1例盆腔正常;9例盆腔粘连(慢性盆腔炎引起7例,手术引起1例,子宫内膜异位引起1例),其中3例子宫后壁与直肠广泛粘连,直肠窝消失;1例盆腔炎症包块;4例子宫内膜异位,其中1例双侧卵巢小巧克力囊肿合并双侧卵巢小畸胎瘤.镜下行盆腔粘连松解,输卵管成形、造口术,内膜异位病灶烧灼、卵巢囊肿剔除、子宫悬吊术.术后腹痛、性交痛、腰酸,肛门坠胀感消失.术后随访1月～1年,3例怀孕.结论:腹腔镜下子宫悬吊术治疗不孕症可完全替代剖腹的子宫悬吊术,减少了患者术后不适,提高了患者的生育功能及生活质量.

Objective：To study the clinical value of ventrifixation by laparoscopy in the treatment of infertility. Methods：Ten patients suffering from both infertility and retroversion retroflexion of uterus had received laparoscopic ventrifixation from January 2001 to July 2002. Results：Under the laparoscopy, 1 patient had a normal pelvis,the other 9 persons got conglutinant pelvis（7 were caused by chronic pelvic inflammation, 1 by operation, 1 by endometriosis） ,3 got wide conglutination between the back wall of uterus and rectum,depression of rectum disappeared;l got pelvic inflammatory cyst ;4 got endometriosis, and one of which got bilateral ovarian cyst and bilateral ovarian small teratoma. Brisement of pelvic adhesion, salpingoplasty, focal cautery of endometriosis enucleation of ovarian cyst,or ventrofixation by laparoscopy were operated on the above 9 patients. After operation, the abdominal ache, coital pain,lumbago, and pain in anus disappeared,Followed up from one month to one year,3 patients got pregnant. Conclusion：Ventrofixation by laparoscopy can completely replace laparotomy in treating infertility. It can obviously relieve discomfort of post-operation and improve the procreant ability and life quality.