宫腔镜联合腹腔镜诊治不孕症108例分析

Laparoscopy Combined with Hysteroscopy for the Diagnosis and Treatment patients with Female Infertility

目的 探讨宫腔镜、腹腔镜联合手术对不孕症患者的诊治价值. 方法 回顾分析宫腔镜-腹腔镜联合手术诊治不孕症患者108例的病因、术后输卵管通畅率及妊娠率. 结果 100例不孕症患者有盆腔异常,其中盆腔炎占58.0%和子宫内膜异位症占28.0%;继发不孕患者中盆腔炎的比例高于原发不孕患者（x2=11.922,P＜0.05）;原发不孕患者中多囊卵巢综合征的比例高于继发不孕患者（x2=5.141,P＜0.05）;子宫输卵管碘油造影与腹腔镜诊断符合率66.4%,假阳性率28.0%,假阴性率4.0%. 结论 宫腔镜-腹腔镜联合检查可早期、明确发现引起原发不孕的原因和病变部位,并能进行相应的治疗,有利于提高妊娠率.

Objective To investigate the value of hysteroscopy combined with laparoscopy in diagnosing and treating patients with infertility. Methods A retrospective analysis of 108 cases with infertile women who had accepted examination and correlative treatment under the combined laparoscopy and hysteroscopy in 5 years was performed. Results By using laparoscopy combined with hysteroscopy,100 cases of pelvic disease（92.5%）were detected in this series.The most common causes of infertility were pelvic inflammation（58.0%）and endometriosis（28.0%）.The incidence rate of pelvic inflammation in secondary infertility patientswas significantly higher than in those with primary infertility（x2=11.922,P〈0.05）;whereas,the rate of polycystic ovarian syndrome in the secondary infertility cases were significantly lower than the primary cases（x2=5.141,P〈0.05）.The diagnostic accordance rate of laparoscopy and hysterosalpingography was 66.4% with a false positive rate of 28.0% and false negative rate of 4.0%. Conclusion The examination by hysteroscopy and laparoscopy could find the reasons of primary infertility as early as possible,but also treat them,which was good for raising the rate of pregnancy.