880例不孕妇女宫-腹腔镜联合手术的病因分析

Diagnosis of 880 Cases of Female Infertility by Hysteroscopy Combined with Laparoscopy

目的:探讨应用宫-腹腔镜联合手术的诊断技术对女性因素不孕病因的诊断价值。方法:对880例不孕症患者经宫-腹腔镜联合手术,诊断其盆腔疾病、宫腔疾病和不孕的可能原因。结果:在880例不孕症患者中,676例患有盆腔粘连,占76.8%;双侧输卵管阻塞者503例,占57.1%;子宫因素者112例,占12.7%;宫腔病变者107例,占12.2%;卵巢因素者103例,占11.7%;生殖器畸形者69例,占7.9%。其中原发不孕者中痛经、多囊卵巢的患者多于继发不孕,而继发不孕者中有盆腔炎症和盆腹腔手术史的比例较多。结论:女性不孕的首要暴露因素(危险因素)是盆腔及生殖道感染性疾病,输卵管阻塞是导致不孕的重要因素之一。应用宫-腹腔镜联合手术对女性不孕症的病因诊断有重要价值并能对盆腔粘连、输卵管疾病在诊断的同时进行治疗。

Objective： To evaluate the diagnosis value of the main pathogen of female infertility by hysteroscopy combined with laparoscopy. Methods： A total of 880 cases of infertility were chosen into the study. The possible factors of the pelvic diseases, uterine cavity diseases and infertility were analyzed by examination of hysteroscopy and laparoscopy. Results： In 880 infertility cases, 676 （76.8%） cases had different degrees of pelvic adhesion, 503 （57.1%） cases had tube block of both sides, 112 （12.7%） cases had uterine diseases, 107 （12.2%） cases had uteri cavity diseases, 103 （11.7%） cases had ovary diseases, 69 （7.9%） cases had genitalia malformation. Women of primary infertility had more chance to have dysmenorrheal, continuity dysmenorrheal and polycystic ovary syndrome, while women of secondary infertility had more chance to have pelvic chronic inflammation and pelvic abdominal surgery. Conclusion： The main risk factor of female infertility was pelvic and genital tract infective diseases, and fallopian tube block was an important factor of infertility. Hysteroscopy combined with laparoscopy played an important part in diagnosis of female infertility, and it could investigate and cure pelvic adhesion and tube diseases.