腹腔镜监测下宫腔镜输卵管插管术治疗输卵管近端梗阻的疗效分析

The Efficacy Analysis in the Treatment of Proximal Tubal Obstruction Using Laparoscopy-guided Hysteroscopic Tubal Catheterization

目的:分析腹腔镜监测下宫腔镜输卵管插管术(laparoscopy-guided hysteroscopic tubal catheterization,LHTC)治疗输卵管近端梗阻的临床疗效。方法:回顾性分析2010年1月—2012年12月因单纯输卵管近端梗阻在中国人民武装警察部队后勤学院附属医院住院行LHTC的336例患者临床资料。术后随访2年,观察其术后妊娠率及妊娠结局。结果:LHTC术中总的输卵管复通率为54.70%,总的患者复通率为63.10%。术后至少一侧输卵管通畅组和未能复通组的术后2年自然妊娠率分别为43.40%和8.06%,活产率分别为33.96%和7.26%,差异均有统计学意义(P<0.05)。结论:行LHTC治疗输卵管近端梗阻的疗效确切,该术式可以作为治疗输卵管近端梗阻的首选方法。

Objective： To investigate the efficacy in the treatment of proximal tubal obstruction using laparoscopy-guided hysteroscopic tubal catheterization（LHTC）. Methods： Data from 336 patients with proximal tubal obstruction who accepted LHTC treatment in the Affiliated Hospital of Logistics College of the Chinese People ′ s Armed Forces from January 2010 to December 2012 were analyzed. After LHTC, a follow-up within 24 months was performed, then pregnancy rate and pregnancy outcome were recorded. Results： The successful recanalization rate was 54.70% per tube and 63.10% per patient. The cumulative pregnancy rate and live birth rate in 2 years of the group whose at least one fallopian was 43.40% and 33.96%;in the group whose fallopian was failed to recanalized, the cumulative pregnancy rate and live birth rate was 8.06% and 7.26%. The difference between the two groups was significant（P〈0.05）. Conclusions： Successful tubal cannulation led to significant improvement in the pregnancy rate as similar efficacy as IVF, which suggests that women with a proximal tubal block could be considered for LHTC as the first choice.