阴道注水腹腔镜与标准腹腔镜对不孕症诊断价值的临床观察

Clinical comparison of transvaginal hydro-laparoscopy with standard diagnostic laparoscopy

目的:比较阴道注水腹腔镜(transvaginalhydrolaparoscopy,THL)与标准腹腔镜(laparoscopy,LAP)对女性不孕症的诊断价值。方法:采用阴道注水腹腔镜及标准腹腔镜检查女性不孕症患者50例,分别将观察结果和手术时间进行比较。结果:THL与LAP比较,手术时间短、住院时间短,诊断符合率为94%。结论:标准腹腔镜具有准确、微创的优点,但存在费用较高、需要住院、需要接受全身麻醉等缺点,阴道注水腹腔镜是既准确、微创,又安全、快速、经济的新方法,可作为不孕症早期诊断的常规检查方法。

Objective： To compare the value and usefulness between transvaginal hydro - laparoscopy （TILL） and standard lapa- roscopy （LAP） in infertile women. Methods： Transvaginal hydrolaparoscopy and standard diagnostic Laparoscopy were performed on 50 infertile women to compare the results of observation and the operation times. Results： 26 patients （52%） had a normal evaluation of the pelvis according to transvaginal hydrolaparoscopy, but 23 patients （46%） according to the standard laparoscopy, abnormal evaluation by TIlL was noted in 23 out of the 26 women who had pelvic abnormality according to the laparoscopic findings. Therefore, normal THL evaluation was inaccurately noted in three women. In all cases of abnormal THL, no normal laparoseopy was noted, hence there was no case of false positive evaluation by THL. The operation times of THL and LAP was （ 11.5 ± 2. 3 ） min and （ 16. 3 ± 6.4 ） min. Conclusion： Although standard diagnostic laparoscopy is considered the gold standard to investigate tubo- peritoneal infertility, it requires general anaesthesia and full operative fftcilities. THL can be performed on an outpatient basis under local anaesthesia, which is a highly accurate technique and a valuable technique for the diagnosis of tubal pathology in cases of abnormal findings or incomplete evaluation comparing with the laparoscopy.