宫腹腔镜手术联合中药治疗近端输卵管性不孕

Treatment of proximal tubal infertility by hysteroscope and laparoscope combined with Chinese medicine

目的探讨宫腹腔镜联合3F导管导丝辅助中药治疗输卵管近端阻塞性不孕的临床价值。方法先采用宫腔镜、腹腔镜和导管导丝三者联合的方法治疗输卵管阻塞89例患者共169条输卵管,术后对成功疏通的86例患者随机分成A、B两组,A组给予中药辅助治疗3个月,B组无特殊治疗。结果 169条输卵管中119条经插入3F导管疏通,未通的50条改为导丝治疗,45条疏通,总的疏通率为97.04%(164/169);疏通成功的86例患者中有34例宫内妊娠,其中,A组妊娠22例,B组妊娠12例,两组之间差异有显著性(P<0.05)。结论宫腹腔镜联合导管导丝可以最大限度地发挥它们的优点,提高输卵管疏通成功率高,术后辅助中药治疗是十分必要的,它提高了术后的妊娠率。

[Objective] To investigate the clinical value of guided wire and Chinese medicine treating the proximal tubal occlusion under hysteroscope combined with laparoscope.[Methods] 169 fallopian tubes with oviduct occlusion from 89 cases were treated with guided wire under hysteroscope combined with laparoscope.After surgery,86 successful patients were randomly divided into A and B groups,group A was given Chinese traditional medicine treatment 3 months,group B was with no special treatment.[Results] 119 of 169 fallopian tubes were cleared out by 3F catheter.50 fallopian tubes were not successful using 3F catheter then conducted with wire inside,45 fallopian tubes were recanalized successfully.In all,164 of 169 fallopian tubes with oviduct occlusion were recanalized successfully.Effective rate was 97.04%（164/169）.There were 34 cases of intrauterine pregnancies in the 86 patients with recovery followed up in more than one year.Among them,there were 22 cases of pregnancy in A group and 12 cases of pregnancy in B group,significant differences was shown between two groups（P 0.05）.[Conclusions] Hysteroscope and laparoscope combined 3F catheter and guidewire in the treatment of proximal tubal occlusion can maximize individual advantages and improve success rate.Postoperative adjuvant treatment of Chinese medicine is necessary,which increases the pregnancy rate after surgery.