腹腔镜诊治女性不孕症疗效及相关因素探讨

Analysis of curative effects and correlation factors in female infertility patients under laparoscopy

目的探讨腹腔镜手术在女性不孕症诊治方面的临床应用及相关影响因素。方法对1998年9月～2006年12月1145例行腹腔镜检查及手术患者的临床资料进行回顾性分析,并对2005年1月～2006年6月414例患者进行随访。结果①在1145例不孕症患者中输卵管病变710例,居首位。②在输卵管病变中,继发不孕患者的发生构成比为67.87%,高于原发不孕(P<0.05);而在子宫内膜异位症、多囊卵巢、盆腔结核、正常盆腔中,原发不孕患者的发生构成比分别为18.63%、7.09%、1.77%和5.99%,均高于继发不孕患者(P<0.05)。③对414例行腹腔镜手术患者进行随访,妊娠率43.28%。术后1年内妊娠者占82.61%,高于1年之后妊娠患者。结论继发不孕者多由输卵管病变所致,而子宫内膜异位症、多囊卵巢、盆腔结核多引起原发不孕;各种疾病行腹腔镜术后1年内为怀孕的最佳时期。

[Objective] To explore clinical effects and correlating factors of laparoscopy applied in the patients of female infertility. [Methods] 1145 cases of female infertility patients were diagnosed and treated by laparoscopy in our hospital from Sept.1998 to Dec.2006, and 414 cases from Jan. 2005 to Jun.2006 receiced follow-up survey. [Results] （1）Among those infertility patients, fallopian tube disease in 710 cases was at the first place. （2）In secondary infertility patients, 67.87% of patients were proved due to fallopian tube diseases, and the constituent ratio was higher than that in primary infertility（P〈0.05）, while in primary infertility, the constituent ratio of endometriosis, polycystic ovary, pelvic tuberculosis, and normal pelvic cavity were 18.63%, 7.09%, 1.77%, 5.99%, which were higher than that in secondary infertility respecfively（P 〈0.05）. （3）The pregnancy rate of 414 cases from Jan.2005 to Jun. 2006 followed-up was 43.28%. 82.61% pregnancy occurred in 1 year after laparoscopy. [Conclusion] （1）Fallopian tube disease plays an important role in secondary infertility. Endometriosis, polycystic ovary, and pelvic tuberculosis are often seen in primary infertility. （2）The best time of pregnancy is within 1 year after laparoscopy.