腹腔镜联合输卵管术中通液治疗输卵管性不孕患者的临床观察

Clinical effect of the laparoscopic re-pregnancy surgery combining with hydrotubation on tubal infertility

目的探讨不孕患者腹腔镜复孕术中行输卵管通液术的临床意义。方法输卵管性不孕患者120例,随机分为实验组和对照组各60例,对照组复孕术中不行输卵管通液术,而于术后第一次月经干净后3~7天行常规输卵管通液治疗,实验组于腹腔镜复孕术中即行输卵管通液术,术后不再行通液治疗。观察两组患者复孕术后盆腔感染发生率、宫内自然妊娠率和异位妊娠率。结果实验组和对照组复孕术后盆腔感染率分别为3.3%（2例）和5.0%（3例）,差异无统计学意义（P〉0.05）;实验组患者平均住院（5.1±0.8）天,对照组平均住院（4.8±0.7）天,组间差异无统计学意义（P〉0.05）。对照组常规通液治疗术后的盆腔感染率为3.3%,实验组为0.0%,差异无统计学意义（P〉0.05）;实验组宫内自然妊娠率为40%（24例）,对照组为21.7%（13例）,差异有统计学意义（P〈0.05）;实验组异位妊娠率为3.3%（2例）,较对照组[5%（3例）]低,但差异无统计学意义（P〉0.05）。结论不孕患者采用腹腔镜复孕术联合术中输卵管通液术,能提高患者宫内自然妊娠率,具有临床应用价值。

Objective To observe the clinical significance of laparoscopic re-pregnancy surgery combining with hydrotubation on tubal infertility and to improve an effective way of natural intrauterine pregnancy rate.Methods 120 patients with tubal infertility were randomly divided into experimental and control group.The patients in the control group were treated with laparoscopic re-pregnancy surgery,followed by a routine hydrotubation at 3-7 days after the first post-operation period.The patients in the experimental group were treated with hydrotubation during the laparoscopic re-pregnancy surgery.The pelvic infection rates after the laparoscopic re-pregnancy surgery in the two groups,the pelvic infection rate after the routine hydrotubation in the control group,the pelvic infection rate after the first post-operation period the natural intrauterine pregnancy rates and the ectopic pregnancy rate in the two groups 1 year later were investigated.Results The pelvic infection cases after the laparoscopic re-pregnancy surgery in the experimental group and in the control group were 2（3.3%） and 3（5.0%）,respectively,without statistical significance（P 0.05）;The average hospital stay of patients were 4.8±0.7 days in the control group and 5.1±0.8 days in the experimental group,without statistical significance（P〉0.05）.The pelvic infection rate after the routine hydrotubation in the control group was 3.3%,the pelvic infection rate after the first post-operation period in the experimental group was 0.0%,without statistical significance（P〉0.05）.The natural intrauterine pregnancy rate was 40% in the experimental group（24 cases）,and 21.7% in the control group（13cases）,with statistical significance（P〈0.05）.The ectopic pregnancy rate was 3.3% in the experimental group（2 cases）,and 5% in the control group（3 cases）,without statistical significance（P〉0.05）.Conclusion Hydrotubation during the laparoscopic re-pregnancy surgery could improve the natural intrauterine pregnancy rate for the tubal infertility patients,and this mean have potential clinical application.