宫腹腔镜联合治疗输卵管性不孕症的临床研究

Clinical research on tubal infertility in the treatment of hysteroscopy combined with Laparoscopy

目的探讨宫腔镜腹腔镜联合行输卵管插管术在治疗输卵管性不孕中的临床价值。方法将86例输卵性不孕患者随机分为A、B两组,即宫腹腔镜联合手术组和单纯宫腔镜下插管通液治疗组。A组在腹腔镜监视下先行宫腔镜输卵管口插管并加压通液术,若失败则沿输卵管口插管插入配套的Coook导丝,疏通输卵管;B组单纯行宫腔镜输卵管口插管并加压通液术。随访1年,比较输卵管通畅率和受孕率。结果 A组46例输卵管通畅率为84.8%,正常受孕率43.5%;B组40例插管通液疏通率55.0%,正常受孕率22.5%。两组比较差异有显著性(P<0.05)。结论宫腹腔镜联合诊治输卵管性不孕明显优于单独宫腔镜下插管通液治疗的效果,受孕率高,是目前治疗输卵管性不孕症的理想方法。

Objective To investigate the clinical value of the joint method of hysteroscopy and laparos- copy in the treatment＂ of tubal intubation infertility. Methods 86 eases of lost eggs infertile patients were ran- domly divided into, laparoscopic surgery group （A group）and simply pass fluid hysteroscopic catheter treatment group（ B group）. A group under the surveillance of first laparoscopic port hysteroscopic tubal catheterization and pressurized fluid-pass surgery, if fuilure, insert along the fallopian tubes mouth tube supporting Coook guide wire, and clear the fallopian tubes ; B group were only performed hysteroscopic tubal cannulation and pressurized fluid-pass surgery. After 1 year＇ s follow-up, compared tubal patency rate and pregnancy rate. Results A group of 46 cases of tubal patency rate was 84.8%, The normal pregnancy rate was 43.5% ; B group of 40 patients intubation rate was 55.0% and the normal pregnancy rate was 22.5%. Difference between the two groups was significant （P ＆lt;0.05 ）. Conclusion In the diagnosis and treatment of tubal infertility, hysteroscopy combined laparoscopy is evidently superior to single-pass fluid hysteroscopic catheterization. Pregnancy rate is high. It is the ideal treatment method of tubal infertility.