腹腔镜诊治女性不孕症盆腔病变临床分析

Clinical Analysis of Laparoscopic Diagnosis & Treatment in Female Infertility with Pelvic Diseases

目的了解腹腔镜技术对女性不孕症患者盆腔病变的诊治价值。方法对2005年3月—2008年12月因不孕症在泰州市中医院行腹腔镜盆腔病变诊治的512例患者进行回顾性分析。术中镜下美兰通液动态观察输卵管通畅情况并施以镜下治疗。结果 512例不孕症患者中,盆腔病变患者486例(94.92%),其中盆腔炎居首位(46.1%),子宫内膜异位症次之(23.8%),多囊卵巢居第3位(19.1%)。盆腔炎、子宫内膜异位症的比率在原发性不孕与继发性不孕症间的差异有统计学意义(P<0.05)。经腹腔镜诊治后,输卵管通畅率提高,宫内妊娠率明显提高,而异位妊娠率在盆腔炎及子宫内膜异位症患者中明显高于多囊卵巢综合征组,差异有统计学意义(P<0.05)。结论腹腔镜手术可以迅速明确不孕症盆腔病因,并可同期施以镜下治疗,同时还可以了解输卵管通常情况,提高妊娠率。

Objective To evaluate the laparoscopic diagnosis treatment value for female infertility patient with pelvic diseases.Methods Retrospectively analyze 512 cases infertility patients from February 2006 to December 2008 who was laparoscopic diagnosed or treated pelvic diseases in our hospital,with methylene blue fluid dynamically examined the conditions of fallopian tubes.Results Pelvic diseases were found 486 in all 512 infertility patients,accounting for 94.92%;Pelvic diseases ranks first,followed by endometriosis,polycystic ovary ranks third.In the secondary and primary infertility,pelvic disease has statistical difference（P0.05）;Endometriosis has statistical difference（P0.05）.After laparoscopic treatment,the tubal patency intrauterine pregnancy rate was significantly increased.But the ectopic pregnancy rate of patients with pelvic diseases and endometriosis was significantly higher than that patients with polycystic ovary syndrome,difference was statistically different（P0.05）.Conclusion Laparoscopic surgery can quickly diagnose the pelvic cause of infertility,with endoscopic therapy,can also examine the conditions of fallopian tubes,improve the pregnancy rate.