阴道注水腹腔镜及标准腹腔镜术在不孕症中应用的临床评价

Evaluating the Value of Transvaginal Hydrolaparoscopy vs Standard Laparoscopy in Patients with Infertility

目的:评价经阴道注水腹腔镜术(THLsc)和标准腹腔镜术(Lsc)在不孕症中的临床应用价值。方法:对88例不孕症患者施行THLsc,观察患者输卵管的通畅性、盆腔病变情况,对需行Lsc诊治的患者,行Lsc诊治。记录2种腹腔镜检查的符合率、术中及术后并发症情况。结果:88例患者THLsc穿刺成功率为94.32%。83例经THLsc检查的患者中,盆腔检查结果正常者39例(46.99%),44例盆腔检查结果有异常(53.01%)。术后需要进一步施行Lsc手术的患者32例(38.55%),其中2种检查方法结果的符合率为87.5%。在术后疼痛方面,THLsc组明显优于Lsc组(P<0.01)。结论:THLsc是一种更加快速、准确、微创、安全的检查方法,可作为女性不孕症患者的早期检查方法,对有盆腔明显病变者,应进行Lsc手术。

Objective：To evaluate the value of transvaginal hydrolaparoscopy（THLsc） vs standardlaparoscopy（Lsc） in patients with infertility.Methods：Eighty-eight infertile patients were performed withTHLsc,Lsc was performed on the patients who needed to be.Main outcome measures were success rateof insertion into the pouch of Douglas,fallopian tube potency,pelvic pathology,intra-and postoperativecomplications and accuracy of THLsc in comparison with Lsc.Results：Success rate of inserting thepouch of Doiglas and performing THLsc was 94.32%,diagnosis for 83 infertile patients were normalpelvis in 39（46.99%）,abnormal pelvis in 44（53.01%）.Only 32（38.55%） patients needed Lsc postoperatively.THLsc results correlated closely with Lsc results in 87.5%.In the postoperative pain,THLsc was superiorto Lsc.Conclusion：THLsc is more feasible,reliable,minimally invasive,safe,economical than Lsc.It can beaccepted as a first step for evaluating infertility patients.In case of significant pelvic lesions,Lsc is recommendedas the second step in the evaluation and treatment.