宫腔镜、腹腔镜治疗输卵管性不孕症的效果及对妊娠结局的影响

Curative effects of hysteroscopy and laparoscopy in treatment of tubal infertility and the effects on pregnancy outcomes

目的分析输卵管性不孕症患者应用宫腔镜、腹腔镜治疗的效果及对妊娠结局的影响。方法选取2013-2016年于佛山市第一人民医院妇科诊治的输卵管不孕症患者115例,随机分为两组,对照组55例患者采取腹腔镜输卵管疏通治疗;研究组的60例患者采取宫腹腔镜联合输卵管疏通术治疗。比较两组患者治疗后的输卵管通畅率,并随访患者术后的妊娠情况。结果研究组患者的输卵管通畅率为93.33%,明显高于对照组患者的76.36%,差异有统计学意义(P<0.05);在术后1年内,研究组患者的成功妊娠率为51.67%,而对照组患者的成功妊娠率仅为43.64%,差异有统计学意义(P<0.05);研究组患者治疗后的并发症发生率为1.67%,其中仅有1例患者下腹胀痛,对照组的并发症发生率为18.18%,下腹胀痛3例、输卵管粘连5例、痉挛2例,两组比较差异有统计学意义(P<0.05)。结论输卵管性不孕症患者采用宫、腹腔镜联合输卵管疏通术治疗,输卵管疏通效果明显,能提高患者术后的妊娠成功率,并且减少并发症的发生。

Objective To analyze the curative effects of hysteroscopy and laparoscopy in treatment of tubal infertility and the effects on pregnancy outcomes. Methods A total of 115 tubal infertility patients treated in the hospital from 2013 to 2016 were selected and randomly divided into two groups： 55 patients in control group were treated by laparoscopic tubal recanalization,and 60 patients in study group were treated by hysteroscopic and laparoscopic tubal recanalization. The rates of tubal patency after treatment in the two groups were compared,the pregnancy rates in the two groups were followed up. Results The rate of tubal patency in study group was 93. 33%,which was statistically significantly higher than that in control group（ 76. 36%）（ P 〈0. 05）; the successful pregnancy rates within one year after operation in study group and control group were 51. 67% and 43. 64%,respectively,there was statistically significant difference between the two groups（ P 〈0. 05）. The incidence rates of complications after treatment in study group and control group were 1. 67%（ one patient with hypogastralgia） and 18. 18%（ 3 patients with hypogastralgia,5 patients with Fallopian tube adhesion,2 patients with spasm）,there was statistically significant difference between the two groups（ P 〈0. 05）. Conclusion The effect of hysteroscopic and laparoscopic tubal recanalization is significant in treatment of tubal infertility,the method can improve the successful pregnancy rate after operation and reduce the incidence rate of complications.