阴道注水腹腔镜宫腔镜联合手术在不孕症诊治中的作用及临床意义

Clinical significance of transvaginal hydrolaparoscopy combined with hysteroscopy operation in the treatment of infertility

目的探讨阴道注水腹腔镜宫腔镜联合手术在不孕症诊治中的临床效果及意义。方法将240例不孕症患者分为三组,研究组107例采用注水腹腔镜(THL)宫腔镜联合手术诊治,对照组103例采用子宫输卵管造影术(HSG)检查与传统标准腹腔镜(Lap)手术。空白对照组30例仅行普通助孕治疗。比较两组的手术穿刺成功情况;两组方法输卵管病变的诊断情况;门诊或者电话随访患者1年内的妊娠结果。结果 THL诊断输卵管病变的敏感度和特异度均明显高于HSG检查(P<0.05),总体符合率也较HSG高,但差异无显著性(P>0.05);研究组成功率98.13%,对照组成功率99.02%,两组间安全性差异无显著性(P>0.05);研究组妊娠率39.25%,对照组妊娠率36.89%,均明显高于未经手术治疗的空白对照组患者(P<0.05)。结论与子宫输卵管造影术(HSG)检查与传统标准腹腔镜(Lap)手术相比较,阴道注水腹腔镜宫腔镜联合手术在不孕症的检查和治疗方面均有明显优势。

Objective To investigate the clinical effect and significance of transvaginal hydrolaparoscopy combined with hysteroscopy operation in the treatment of infertility. Methods 210 cases of infertility patients in our hospital were divided into two groups,study group（ 107 cases） used hydrolaparoscopy（ THL） in diagnosis and treatment of hysteroscopy combined with operation,control group（ 103 cases） with hysterosalpingography（ HSG） and conventional laparoscopic examination standard（ Lap） operation,operation of comparative research on group and control group; at the same time with and without the operation of the blank control group with in 1 years of pregnancy outcome. Results THL diagnosis of tubal lesion sensitivity and specificity were significantly higher than that of HSG examination（ P〈0. 05）,agreement rate is higher than that of HSG in general,but the difference was not significant（ P〈0. 05）. The success rate of study group was 98. 13%,control group 99. 02%,and the safety has no significant difference between the two groups（ P〈0. 05）. Pregnancy rate in the study group was 39. 25%,control group 36.89%,and they were obviously higher than the blank operation treatment of patients in the control group（ P〈0. 05）. Conclusion Transvaginal hydrolaparoscopy combined with hysteroscopy operation,have obvious advantage in the aspects of examination and treatment of infertility.