宫腹腔镜联合诊治输卵管性不孕107例临床分析

Clinic Analysis of Laparoscopy combined with Hysteroscopy in Diagnosing and Treatment of 107 Cases with Tubal Infertility

目的探讨宫腹腔镜联合诊治输卵管性不孕的临床应用价值。方法对107例因输卵管原因引起的不孕症患者采用宫腔镜联合腹腔镜进行诊断和治疗,并对结果进行回顾性分析。结果 107例患者中盆腔粘连44例(41.12%)、子宫内膜异位症25例(23.36%),是不孕症的主要病因。病变输卵管178条,手术复通115条,复通率64.61%。壶腹部、伞部阻塞术后再通率89.90%,明显高于间质部、峡部阻塞的输卵管再通率(22.73%、36.84%)。术后随访78例,39例受孕(受孕率50%),其中宫内妊娠35例,异位妊娠4例。结论宫腔镜、腹腔镜联合手术可明确不孕症病因,同时可对输卵管病变进行诊断与治疗,其创伤小、并发症少、安全有效,具有重要的临床应用价值。

Objective To explore the clinic value of laparoscopy combined with hysteroscopy in diagnosing and treatment of tubal infertility.Methods One hundred and seven cases tubal infertility were diagnosed and treated by laparoscopy combined with hysteroscopy,and retrospective analysis the treament outcome.Results Among all of 107 cases with tubal infertility,the cause of 44 cases was pelvic adherence（41.12%）,and 24 patients had endometriosis（23.36%）.The successful rate was 64.61% in the 178 obstructed oviducts.The rate of recanalization was significant higher in ampulla and fimbriae of fallopian tube（89.90%）than in interstitial part of fallopian tube（22.23%）and tubal isthmus（36.84%）.78 cases were followed up in postoperation,39 cases conception（conception rate 50%）,35 cases intrauterine pregnancies,4 cases ectopic pregnancy.Conclusion Safe,effective,and less traumatic are characteristics of the operation combined laparoscopy and hysteroscopy which has important clinical values in the diagnosis and therapy of the tubal infertility patients.