腹、宫腔镜联合诊治女陛不孕症374例临床分析

Clinical study of hysteroscope combined with abdominoscope on the diagnosis and therapy of female infertility

目的探讨腹腔镜、宫腔镜联合应用在女性不孕症诊治中的疗效。方法回顾分析374例女性不孕症患者（包括原发性及继发性不孕）应用腹、宫腔镜联合诊治的临床资料。分析其病因；比较腹、宫腔镜联合检查和单独检查结果的差异；比较子宫输卵管碘油造影与输卵管捅管通液的通畅率，观察输卯管手术后的再通率。结果不孕病因主要有盆腔粘连（占50．80）％，输卯管阻塞（占42．25％），盆腔子宫内膜异位症（占25．67％），子宫内膜息肉（占13．90％），多囊卵巢（占11．76％），子宫肌瘤（占6．42％）。腹、宫腔镜联合检查阳性率高于二者单独检查。输卵管插管通液／疏通术较子宫输卵管造影通畅率差异有显著性（P〈0．01），腹、宫腔镜联合手术后输卵管再通率为40．92％。结论应用宫腔镜、腹腔镜联合诊治术能直观、准确、全面地了解不孕症在盆腔、宫腔方面的病因，并予以针对性治疗。

Objective To study the effects of hysteroscope combined with abdominoscope on the diagnosis and therapy of female infertility. Methods Clinical data of being diagnosed and thcrapied with hysteroscope and abdominoscope in 374 infertility cases were retrospectively analyzed. Explained the etiological factors and compared the positive rates among hysteroscope combined with abdominoscope, hysteroscope alone and abdominoscope alone. The patency rates were compared between hysterosalpingography and hydrotubation, and the recanalization rates of uterine tubes after operations were observed. Results The main causes of female infertility were pelvic affixion （50.80%）, salpingemphraxis （42.25%）, pelvic endometriosis （25.67%）, endometrial polypus （13.90%）, polycystic ovary （11.76%） and hysteromyoma （6.42%）. The positive rate of hysteroscope combined with abdominoscope was obviously higher than the others. There was a significant deviation of oviductal patency rates between hysterosalpingography and hydrotubation. The recanalization rate of uterine tubes after the operation was 40. 92%. Conclusion Hysteroscope combined with abdominoscope could comprehend the etiopathogenisis and heal the diseases of infertility in cavitas pelvis and uterine cavity with advantage of directly, exactly and overall.