腹腔镜联合宫腔镜诊治女性不孕症的临床应用价值

The clinical value of laparoscopy combined with hysteroscopy in the diagnosis and treatment of female infertility

目的探讨腹腔镜联合宫腔镜诊治女性不孕症的临床价值,为临床诊治女性不孕症提供指导。方法选取2009年6月～2012年6月本院收治的女性不孕症患者150例,采用腹腔镜联合宫腔镜进行诊治,并观察临床治疗效果。结果慢性盆腔炎、子宫内膜异位症、多囊卵巢综合征、盆腔结核以及生殖器发育异常是女性不孕的主要原因;慢性盆腔炎76例,占50.7%,继发不孕发生率高于原发不孕,两者差异有统计学意义(P<0.05);子宫内膜异位症32例,占21.3%;多囊卵巢18例,占12.0%;盆腔结核15例,占10.0%;生殖器发育异常9例,占6.0%,原发不孕发生率高于继发不孕,两者差异有统计学意义(P<0.05);通过腹腔镜联合宫腔镜治疗,60例患者术后妊娠,妊娠率为40.0%,发生异位妊娠9例(6.0%)。结论腹腔镜联合宫腔镜诊治女性不孕症能够明显提高诊断率,有效提高术后妊娠率,具有重要的临床应用价值。

Objective To investigate the laparoscopy combined with hysteroscopy in the treatment of female infertility clinical application value, provides some guidance for clinical diagnosis and treatment of female infertility. Methods 150 cases of female infertility patients using laparoscopy combined with hysteroscopy in the diagnosis and treatment in our hospital from June 2009 to June 2012 were retrospectively analyzed, and the causes, diagnosis and clinical treat- ment effect was observed. Results Chronic pelvic inflammatory disease, endometriosis, polycystic ovaries, pelvic tuber- culosis and genital development abnormality were the main reason for female infertility; 76 cases of chronic pelvic in- flammatory disease, accounting for 50.7%, secondary infertility was more than the original infertility, there are statisti- cal differences （P 〈 0.05）; endometriosis was in 32 cases, accounting for 21.3%; polycystic ovary was in 18 cases （12.0%）, 15 cases of pelvic tuberculosis, accounting for 10.0%; genital abnormalities was in 9 cases, accounting for 6.0%; the incidence of secondary infertility was higher, there was statistical differences （P 〈 0.05）; treatment by la- paroscopy combined with hysteroscopy, 60 patients with postoperative pregnancy, the pregnancy rate was 40.0%, ec- topic pregnancy occurs in 9 cases （6.0%）. Conclusion Laparoscopy combined with hysteroscopy in the diagnosis and treatment of female infertility can improve diagnosis rate significantly, and can effectively improve the postoperative pregnancy rate, has important clinical value.