宫腔镜-B超联合输卵管插管诊治395例女性不孕症临床分析

Clinical analysis on 395 infertile women diagnosed and treated with tubal catheterization under hysteroscope combined with type-B ultrasound

目的:探讨宫腔镜-B超联合输卵管插管诊治女性不孕症的临床价值。方法:对2008年1月1日～12月31日佛山市妇幼保健院宫腔镜-B超联合输卵管插管诊治的395例女性不孕症进行14～26个月的随访,了解患者的妊娠率、宫外孕发生率及最后结局。结果:395例患者输卵管疏通率71.00%,术后平均受孕时间(6.26±4.62)个月,术后妊娠率27.00%,自然流产率14.00%,宫外孕发生率3.87%。结论:宫腔镜-B超联合输卵管插管作为女性不孕症的初筛方法至少可以使1/4的女性不孕症患者避免腹腔镜手术或IVF-ET而获得妊娠;另外可以筛选出双侧输卵管伞端粘连及盆腔粘连的不孕症患者接受宫-腹腔镜手术;筛选出双侧输卵管严重堵塞或原因不明或男方因素的不孕症患者接受IVF-ET。

Objective：To explore the clinical value of tubal catheterization under hysteroscope combined with type-B ultrasound in diagnosis and treatment of female infertility. Methods：395 infertile women who were diagnosed and treated with tubal catheterization under hysteroscope combined with type-B ultrasound in the hospital from January 1st to December 30th in 2008 were followed up for 14~26 months;the data including the pregnancy rate,the incidence of ectopic pregnancy and terminal outcome were obtained. Results：The rate of tubal patency after treatment was 71.00%,the average fertilization time was（6.26±4.62） months,the pregnancy rate was 27.00%,the incidence of spontaneous abortion was 14.00%,the incidence of ectopic pregnancy was 3.87%. Conclusion：As a primary screening method for female infertility,tubal catheterization under hysteroscope combined with type-B ultrasound can enable at least a quarter of the infertile women to gain natural pregnancy without laparoscopic surgery or IVF-ET.In addition,the cases suffering from adhesion in bilateral fimbriated extremity can be screened out to undergo further laparoscopic treatment or IVF-ET,meanwhile,the cases with serious obstruction in bilateral tubes and unknown cause or male cause can also be screened out for IVF-ET.