腹腔镜下PK与双极电系统治疗输卵管伞端粘连闭锁伴不孕的临床效果比较

Comparison between PlasmaKinetic System and Bipolarcoagulation in Laparoscopic Treatment of Patients with Infertility and Distal Tube Obstructed

目的比较PK刀和双极电刀在腹腔镜手术中治疗输卵管伞端粘连闭锁伴不孕的疗效。方法2004年5月至2006年10月在我院因输卵管伞端粘连闭锁伴不孕的Ⅱ、Ⅲ期患者64例,其中PK刀组32例,双极电刀组32例,在腹腔镜下行输卵管粘连松解、输卵管造口术,比较术中、术后情况和妊娠率。结果两组手术时间、术中出血量、术后肛门恢复排气时间、术后住院天数等差异均无显著性意义(P>0.05),但PK刀组术后妊娠率为56.67%,双极组术后妊娠率为27.59%,两组比较差异有显著性(χ2=5.107,P<0.05)。结论腹腔镜手术在治疗Ⅱ、Ⅲ期输卵管伞端粘连闭锁伴不孕中,PK刀组妊娠率高于双极组,与PK刀在输卵管成形术中对输卵管损伤较小,有利于恢复输卵管伞与卵巢的解剖关系和拾卵功能有关。

Objective To compare the efficacy of PlasmaKinefic System and bipolar coagulation in laparoscopic salpingostomy in infertile women with distal tube obstruction. Methods From May 2004 to Octorber 2006 according to the extent of tube and pelvic lesion, 64 patients of stage Ⅱ, stageⅢ were treated with laparoscopic salpingostomy. 32 cases were operated by plasma kinetic system （group A）, and 32 cases were operated by bipolar coagulation（group B）. The intraoperative stuation, postoperative stuation and total postoperative pregnancy rate were compared. Result There were no significiant differance between group A and group B in operation time, intraoperative blood loss, postoperative anal-exsuffiation time, and the length of postoperative hospitalization.The pregnancy rate was 56.67% in group A, 27.59% in group B with significant difference （X2=5.107, P 〈0.05） . Conclusion Laprascopy salpigostery were treated in infertile women with distal tube ob- stution at stage Ⅱ, stageⅢ. The total pregnancy rate in group A showed better than that in group B. In laparoscopic salpingostomy, PlasmaKinetic System can benefit in restoring tube, ovarian anatomy and function.