摘要
目的探讨腹腔镜手术治疗因输卵管积水导致不孕症的临床疗效以及影响受孕的因素。方法回顾分析2009年12月—2011年12月间术前行子宫输卵管碘油造影及B超明确诊断,并行腹腔镜和(或)联合宫腔镜手术治疗输卵管积水导致不孕的患者共215例,随访术后妊娠率。结果其中182例完成随访,随访率为84.65%,术后30个月内受孕者55例(32.21%)。厚壁型积水患者术后妊娠率明显高于薄壁型积水患者(35.43%vs 18.18%,P<0.05)。输卵管积水最大直径<3 cm者术后受孕率明显高于>3 cm者(38.01%vs 14.75%,P<0.05)。双侧通畅者术后受孕率高于单侧通畅者(34.48%vs 18.94%,P<0.05)。不孕时间<5年者受孕率高于>5年者(37.03%vs 20.27%,P<0.05)。后陷凹未封闭者术后受孕率略高于后陷凹封闭者(31.81%vs 29.31%,P>0.05)。结论⑴厚壁型输卵管积水患者其输卵管伞端结构正常者术后受孕几率较高。⑵输卵管积水最大直径<3 cm、双侧输卵管通畅以及不孕年限<5年的患者术后受孕几率较高。⑶术后受孕几率与后陷凹是否封闭无明显相关性。
OBJECTIVE To discuss the practice impact and influencing factors on pregnancy rate after laparoscope surgery for hydrosalpinx infertility.METHODS Through hysterosalpingography and B ultrasonic,total 215 cases of pregnancy rate of hydrosalpinx infertility who accepted combination of laparoscope surgery and hysteroscopy has been reviewed retrospectively from Dec 2009 to Dec 2011.RESULTS 182 cases have been completed the follow-up visit,and the follow-up rate is 84.65%,the overall post-operative pregnancy rate is 32.21%（55 cases）.Hydrosalpinx infertile patients with normal fimbriae tube had higher pregnancy rate than patients with disappearing fimbriae tube（35.43% vs 18.18%,P〈0.05）.Maximum diameter of hydrosalpinx infertile patients with less than 3 cm had higher pregnancy rate than patients with lager than 3 cm（38.01% vs 14.75%,P〈0.05）.The diagnosis of bilateral unobstructed tubes had higher pregnancy rate than one-side obstructed tube（34.48% vs 18.94%,P〈0.05）.The infertile patients within five years of medical history had a higher pregnancy rate than longer medical history（37.03% vs 20.27%,P 0.05）.The closed pouch of douglos of patients had better pregnancy rate than patients with opened pouch of douglos（31.81% vs 29.31%,P 0.05）.CONCLUSION ⑴ Hydrosalpinx infertile patients with normal fimbriated fallopian had a higher pregnancy rate than patients with disappearing fimbriated fallopian.⑵ Maximum diameter of hydrosalpinx infertile patients with less than 3 cm,bilateral open fallopian tube and time limit of infertility（less than 5 years） had higher pregnancy rate.⑶ The closed pouch of douglos is not obviously related to post-operative pregnancy rate.
出处
《中国初级卫生保健》
2013年第9期56-58,共3页
Chinese Primary Health Care
