宫-腹腔镜联合手术诊治输卵管性不孕症的临床分析

Clinical study on oviduct sterilities treated by hysteroscopy combined with laparoscopy

目的探讨宫-腹腔镜联合手术治疗输卵管性不孕症的效果。方法对58例输卵管性不孕的患者,同时应用宫、腹腔镜联合治疗,腹腔镜下行盆腔、输卵管、卵巢周围粘连松解术,输卵管伞成形术,输卵管造口术,盆腔子宫内膜异位症手术,中肾管囊肿摘除术；宫腔镜下行输卵管疏通术,子宫内膜息肉摘除术。结果58例不孕症患者中,慢性盆腔炎占51．7%,子宫内膜异位症占29．3%,多囊卵巢综合征占8．6%,盆腔结核占6．9%,正常盆腔占3．5%。术后1年内妊娠率为34．5%。结论联合应用宫、腹腔镜对输卵管性不孕具有很好的诊治价值,能明显提高手术成功率,值得推广应用。

Objective To analyze the effects of hysteroscopy combined with laparoscopy in patients with oviduct sterility. Methods All 58 cases were performed hysteroscopy combined with laparoscopy. Laparoscpic proce dures included pelvic adhesion separation and salpingo-ovariolysis, salpingo-neostomy, operation of pelvic endometriosis, Wolffian duct cystectomy and hysteroscopic procedures consisted mainly as resection of endometrial polyp. Results Among the 58 cases with tubal infertility, chronic pelvic inflammatory disease was present in 51.7%, endometriosis 29.3%, polycystic ovary syndrome 8.6%, pelvic tuberceulosis 6.9%, and normal pelvic cavity 3.5%. The pregnancy rates after operation was 34.5 % in a follow-up period of one year. Conclusions Hysteroscopy combined with laparoscopy is valuable in improving the diagnostic accuracy and effective treatment of tubal infertility with obvious increase of the successful rate of operation, and worthy wider application.