腹腔镜技术在诊治不孕症中的应用

Application study of the laparoscope in the diagnosis and treatment of female infertility

目的探讨腹腔镜手术在诊断和治疗女性不孕中的价值和治疗后卵巢储备功能变化情况。方法收集该科2008年1月～2011年6月治疗的158例不孕症患者的临床资料,分为腹腔镜治疗组(观察组)和保守治疗组(对照组),观察对比两组病因构成,并对患者治疗后妊娠情况及卵巢储备功能进行随访。结果两组患者都以输卵管病变和盆腔病变为多见,观察组子宫内膜异位症占12.79%,对照组2.78%,差异有显著性(P<0.05);不明原因不孕观察组占1.16%,远低于对照组11.11%(P<0.05),治疗后通过随访,观察组妊娠45例,妊娠率达52.33%,对照组妊娠21例,妊娠率为29.17%,两组比较差异有显著性(P<0.05)。观察组治疗后的血清FSH和E2水平低于对照组(P<0.05),并且观察组治疗后的血清FSH和E2水平较治疗前降低明显(P<0.05)。结论应用腹腔镜可明确诊断及不孕症的盆腔病因,同时进行手术治疗,术后妊娠率明显提高,卵巢储备功能有所恢复。腹腔镜技术对不孕症的诊断和治疗有重要价值。

[Objective]To assess the efficacy of laparoscopy in diagnosis and treatment of women with infertility and evaluate the ovarian reserve function change after the laparoscopic operation. [Methods]367 female infertile patients who underwent laparoscopic operation in our hospital during Jan.2008 and June 2011 were analyzed,and they were divided into observation group and control group randomly. The distribution of the disease causes was ana- lyzed, their pregnancy rate and ovarian reserve function changes were followed up.[Result]Uterine tube and pelvic diseases were the factors that led to infertility.12.79% of the total having endometriosis in observation group,and that was 2.78% in control group. There was significant difference between the two groups （P 0.05）. Unbeknown infertili- ty in observation group （1.16%） was significantly lower than that of the control group （11.11%）. By follow up after treatment, 45 patients were pregnant,the rate was 52.33% in observation group, 21 patients were pregnant, the rate was 29.17% in control group,There was significant difference between the two groups （P 0.05）. After treatment, the levels of FSH and E2 in observation group were significantly lower than that of control （P 0.05）, the levels of FSH and E2 were significantly decreased in observation group after treatment （P 0.05）.[Conclusion]Laparoscopy can be used to identify the pelivic diseases related to infertility and to perform operation simultaneously and to increase the pregnancy rate. The ovarian reserve function in patients can be improved after laparoscopic operation. La- paroscopy has important value of diagnosis and treatment in female infertility.