宫腹腔镜联合诊治不孕症效果分析

Laparoscopy combined with hysteroscopy for diagnosis and treatment of infertility.

目的探讨宫腔镜和腹腔镜联合应用诊治不孕症的临床价值。方法选取我院2007年7月至2009年7月收治的76例不孕症患者,均进行宫腹腔镜联合手术。结果76例不孕症中,宫腔镜检查发现正常宫腔61例,宫腔粘连2例,子宫纵隔3例,子宫黏膜下肌瘤3例,子宫内膜息肉7例;腹腔镜检查发现正常盆腔8例,盆腔粘连48例,子宫内膜异位症20例,多囊卵巢综合征5例,单侧输卵管堵塞25例,双侧输卵管堵塞22例,子宫肌瘤3例,卵巢囊肿2例。经腹腔镜治疗后双侧输卵管通畅35例,单侧输卵管通畅31例,双侧输卵管堵塞10例,术后跟踪随访50例,妊娠23例。结论宫腹腔镜联合手术能够明确不孕症的病因,同时进行治疗,多数患者获得再次受孕机会,对于双侧输卵管堵塞严重者建议体外受精胚胎移植(IVF-ET),避免不必要的治疗,具有良好的社会价值和经济价值。

Objective To study the clinical value of laparoscopy combined with hysteroscopy for diagnosis and treatment of infertility.Methods 76 cases of infertility（from July 2007 to July 2009） had been undergone by laparoscopy combined with hysteroscopy.Results In 76 cases with infertility,there were 61 cases with normal uterine cavity by hysteroscopy test,2 cases wi intrauterine adhesions,3 cases with uterine septum,3 cases with submucous hysteromyomas,and 7 cases with endometrial polyps;there were 8 cases with normal pelvic cavity by laparoscopy test,48 cases with pelvic adhesions,20 cases with endometriosis,5 cases with polycystic ovarian syndrome,25 cases with unilaterally blocked tube,22cases with bilaterally blocked tubes,3 cases with uterine myoma,2 cases with ovarian cyst.35 cases had been passable in bilateral tubes after treatment by laparoscopy,31 cases with unilaterally passable tube,10 cases with bilaterally impassable tubes.50 cases had been followed-up,and 23 cases were pregnant.Conclusion The causes of infertility can be found out,and partial patients can achieve the chance of pregnancy again after treatment by laparoscopy combined with hysteroscopy.The patients of badly unilateral blocked tube should undergo IVF-ET,avoiding unnecessary treatment.