宫腔镜下输卵管插管通液治疗术对盆腔粘连不孕的诊治价值探讨

Diagnosis and treatment of pelvic adhesion-related infertility by hysteroscopic tubal catheterization and hydrotubation

目的探讨宫腔镜下输卵管插管通液治疗术对盆腔粘连不孕的诊治价值。方法本研究共收集本院科盆腔粘连不孕患者70例,采用随机数字分配法分为治疗组与对照组,治疗组35例,对照组35例,对照组予以传统输卵管通液治疗术治疗,治疗组应用宫腔镜下输卵管插管通液治疗术进行治疗,实验结束记录、分析以及比较两组患者的临床疗效、HSG满意度、B超满意度、疗效满意度、粘连评分、性激素水平、输卵管通畅率、妊娠率及不良反应发生情况。结果与治疗前相比,两组患者治疗后粘连评分降低(P<0.05),FSH以及E2水平无改变(P>0.05),两组T、LH及LH/FSH比值降低(P<0.05),两组SHBG水平升高(P<0.05)。与对照组相比,治疗组总有效率较高(P<0.05),粘连评分较低,HSG满意度、疗效满意度、B超满意度较高(P<0.05),T、LH及LH/FSH比值较低(P<0.05),SHBG水平较高(P<0.05),治疗组输卵管通畅率、6个月内妊娠率较高,不通畅率较低(P<0.05)。结论宫腔镜下输卵管插管通液治疗术对盆腔粘连不孕女性具有增高妊娠成功率,改善激素水平,治疗不孕的作用,临床疗效理想。

Objective To evaluate the value of hysteroscopic tubal catheterization and hydrotubation in the diagnosis and treatment of pelvic adhesion-related infertility. Methods A total of 70 cases of adhesion-related infertility in the Department of Obstetrics and Gynecology were collected in this study. The patients were randomly divided into treatment group（n=35） and control group（n=35） according to random number allocation method. The control group was treated with traditional tubal hydrotubati0n.The treatment group was given hysteroscopic tubal catheterization and hydrotuba- tion. The clinical efficacy, HSG satisfaction, ultrasound satisfaction, efficacy satisfaction, adhesion score, sex hormone level, tubal patency rate, pregnancy rate and adverse reactions of the two groups were recorded,analyzed and compared. Results Compared with those before treatment, the adhesion scores in the two groups were decreased（P〈0.05）, the levels of FSH and E2 did not change（P〉0.05）. T, LH and LH/FSH were decreased in both groups（P〈0.05）, and the level of SHBG was increased（P〈0.05）. Compared with those in the control group, the total effective rate was higher, the score of adhesion was lower, HSG satisfaction, ultrasound satisfaction and the curative effect satisfaction were higher; T, LH and LH/FSH were lower（P〈0.05）, the level of SHBG was higher in the treatment group（P〈O.05）. The rate of tubal patency and pregnancy rate in 6 monty were higher, and obstruction rate was lower in the treatment （P〈0.05）. Conclusion Hys- teroscopic tubal catheterization and hydrotubation has the effects of increasing pregnancy success rate, improving hor- mone level and treating infertility, and its clinical curative effects are ideal.