宫腔镜、腹腔镜联合手术诊治输卵管性不孕症临床分析

Clinical study on oviduct infertility cases performed under hysteroscopy combined with laparoscopy

目的：探讨宫腔镜、腹腔镜联合手术诊治输卵管性不孕的手术方式及应用价值。方法：对2000年3月-2006年7月住我院的100例因输卵管原因引起的不孕症患者采用宫腔镜、腹腔镜联合手术进行检查、诊断，并视术中的不同情况进行不同的手术方式治疗，术后6个月进行随访。结果：本组100例病人200根输卵管，发现病变149根，手术复通95根，复通率63．76％。壶腹部、伞部阻塞术后复通率（87．64％）明显高于间质部和峡部阻塞的术后复通率（22．22％、30．95％），差异有非常显著意义（P〈0．0001）。术后≥6个月随访到的43例患者，有16例妊娠，妊娠率为37．20％。结论：宫腔镜、腹腔镜联合手术能同时对输卵管病变者进行诊断与治疗，创伤小、恢复快，手术成功率高，术后妊娠率较满意，是输卵管性不孕病人的首选治疗方法。

Objective： To explore the clinical value of using hystcroscopy combined with laparoscopy in diagnosis and treatment the patients with oviduct infertility. Methods： From March 2000 to July 2006, 100 cases with oviduct infertility were diagnosed and treated under hysteroscopy combined with laparoscopy and were followed up 6 months after surgery. Results： Among the 200 oviducts of those 100 patients, ld9 were with damages and 95 were success treated. The success rate was 63.76%. Those that obstructed in ampullary and fimbriaend portions of fallopian tube were with better success treatment rate （87. 64% ） than that obstructed in interstitial and sisthmus portion of the tube. （22. 22%, 30. 95% ） （ P 〈 0. 0001 ） . There were d3 cases be followed more than 6 months after surgery and 16 cases got pregnant （37. 2% ） . Conclusion： Hysteroscopy combined with laparoscopy get the benefits of to diagnosis and treat the damages of oviducts at same time. Which is the first option for oviduct infertility, due to less trauma, quick recovery higher success rate and better pregnant rate.