腹腔镜输卵管复通术联合中药治疗输卵管近端阻塞性不孕

Laparoscopic salpingostomy combined with traditional Chinese medicine in treatment of proximal tubal obstruction induced infertility

目的:探讨腹腔镜输卵管复通术联合中药治疗输卵管近端阻塞性不孕的疗效。方法:2006年4月～2009年10月61例实施腹腔镜输卵管再通术患者,其中实施输卵管吻合术45例,实施输卵管宫角植入术16例,术后口服道地通管一号方及道地通管二号方保留灌肠三个疗程;随访3～24个月统计妊娠情况。结果:61例手术均获成功,无中转开腹。术后随访,输卵管绝育术后患者宫内妊娠率88.00%,宫外妊娠率为0.00;结节性输卵管炎患者宫内妊娠率50.00%,宫外妊娠率8.33%,炎症纤维化阻塞患者宫内妊娠率31.25%,宫外妊娠率12.5%;子宫内膜异位症患者宫内妊娠率62.50%,宫外妊娠率为0.00。结论:腹腔镜输卵管复通术联合中药治疗输卵管近端阻塞性不孕能有效提高妊娠率。

Objective： To explore the curative effect of laparoscopic salpingostomy combined with traditional Chinese medicine in treatment of proximal tubal obstruction induced infertility. Methods： From April 2006 to October 2009, 61 cases underwent laparoscopic sal- pingostomy, including 45 cases undergoing tubal anastomosis and 16 cases undergoing cornual implantation of fallopian tubes ; after operation, the cases were treated with traditional Chinese medicine （ the first daoditongguan decoction and the second daoditongguan decoction, respectively） for three courses; after follow -up for 3 -24 months, the pregnancy conditions were analyzed statistically. Results： The operation was completed successfully in 61 cases, no cases converted to laparotomy. During follow -up, among the cases after tubal sterilization, the intrauterine pregnancy rate was 88.00%, the extrauterine pregnancy rate was 0. 00% ; among the cases with salpingitis isthmica nodosa, the intrauterine pregnancy rate was 50.00%, the extrauterine pregnancy rate was 8. 33% ; among the cases with inflammatory fibrosis obstruction, the intrauterine pregnancy rate was 31.25%, the extrauterine pregnancy rate was 12. 5% ; among the cases with endometriosis, the intrauterine pregnancy rate was 62. 50%, the extrauterine pregnancy rate was 0. 00%. Conclusion： Laparoscopic salpingostomy combined with traditional Chinese medicine can increase pregnancy rate effectively in treatment of proximal tubal obstruction induced infertility.