不孕妇女输卵管积水中病原体检测及腹腔镜手术治疗观察

The Pathogen Detection of Hydrosalpinx and Treatment Observation of Laparoscopic Surgery of the Infertile Female

目的:观察不孕妇女输卵管积水中病原体检测及腹腔镜手术治疗效果。方法:选取笔者所在医院2014年1月-2015年9月115例输卵管积水不孕患者,使用聚合酶链反应检查输卵管积水及宫颈分泌物,测定淋球菌、沙眼衣原体及解脲支原体;所有患者均进行腹腔镜手术,术后随访6个月,观察术后疗效,并分析影响妊娠的因素。结果:输卵管积水沙眼衣原体阳性率为26.09%,宫颈分泌物阳性率为23.48%,比较差异无统计学意义(P>0.05),输卵管积水解脲支原体阳性率为6.09%,宫颈分泌物阳性率为51.30%,比较差异有统计学意义(P<0.05);腹腔镜术后总妊娠率为33.91%;轻度及中度输卵管积水患者妊娠率高于重度输卵管积水患者,比较差异有统计学意义(P<0.05),轻度及中度输卵管积水患者沙眼衣原体阳性率低于重度输卵管积水患者,比较差异有统计学意义(P<0.05)。结论:输卵管积水中沙眼衣原体感染率较高,腹腔镜手术治疗输卵管积水不孕效果明显,术后妊娠率可能与沙眼衣原体阳性率、输卵管积水程度相关。

Objective：To observe the pathogen detection of hydrosalpinx and treatment observation of laparoscopic surgery of the infertile female.Method：115 cases of infertile patients caused by hydrosalpinx were selected in the author＇s hospital from January 2014 to September 2015,the hydrosalpinx and cervical wecretion were examined by polymerase chain reaction,and the gonococcus,chlamydia trachomatis and mycoplasma urealytium were measured.All the patients was given the laparoscopic surgery,and followed up for 6 months after operation.The postoperative effect was observed and the elements that affected the gestation were analyzed.Result：The positive rate of chlamydia trachomatis in the hydrosalpinx was 26.09%,and the positive rate of chlamydia trachomatis in the cervical wecretion was 23.48%,the difference was not statistically significant（P0.05）.The positive rate of ureaplasma urealyticum in the hydrosalpinx was 6.09%,and the positive rate of ureaplasma urealyticum in the cervical wecretion was 51.30%,the difference was statistically significant（P0.05）.The laparoscopic postoperative pregnancy rate was 33.91%.The pregnancy rate of the patients with mild-to-moderate hydrosalpinx was higher than that of the patients with serious hydrosalpinx,the difference was statistically significant（P0.05）.The positive rate of chlamydia trachomatis of the patients with mild-to-moderate hydrosalpinx was lower than that of the patients with serious hydrosalpinx,the difference was statistically significant（P0.05）.Conclusion：Chlamydia pneumoniae infection rate is higher in the fallopian tube,the effect of laparoscopic surgery treatment of hydrosalpinx infertility is obvious.The postoperative pregnancy rate is possibly related to the positive rate of the chlamydia trachomatis and the degree of the hydrosalpinx.