腹腔镜联合宫腔镜治疗不孕不育症的临床效果及安全性

Clinical effect and safety of laparoscopy combined with hysteroscopy in treatment of infertility

目的探讨腹腔镜联合宫腔镜治疗不孕不育症的疗效及安全性。方法将2015年1月～2016年11月在我院行择期手术治疗的102例输卵管性不孕不育症患者按随机单盲法分为对照组和观察组各51例,观察组51例采用腹腔镜联合宫腔镜手术治疗,对照组51例采用腹腔镜手术治疗,并对两组患者的手术相关指标、输卵管通畅率及妊娠率、并发症发生率进行比较。结果观察组术中失血量(45.21±17.30)ml、手术时间(62.01±4.28)min、术后首次排气时间(1.47±0.48)天、住院时间(8.81±0.98)天,对照组术中失血量(44.26±16.37)ml、手术时间(61.35±5.27)min、术后首次排气时间(1.50±0.52)天、住院时间(8.69±1.07)天,两组患者各指标比较差异无统计学意义(P>0.05);观察组的输卵管总通畅率为94.12%、妊娠成功率为76.47%高于对照组的76.47%和56.86%,并发症发生率为3.92%低于对照组的19.61%,差异均有统计学意义(P<0.05)。结论相较于腹腔镜手术,腹腔镜联合宫腔镜治疗不孕不育症的效果确切,可提升输卵管疏通效果,提高妊娠成功率,且并发症发生率低,创伤性小,安全性高。

Objective To investigate the efficacy and safety of laparoscopy combined with hysteroscopy in the treatment of infertility.Methods From January2015to November2016marked in our hospital102cases of surgical treatment of oviduct infertility patients according to the random single blind method was divided into control group and observation group(each group of51cases).In the observation group,51cases were treated with laparoscopy combined with hysteroscopy,while in the control group,51cases were treated with laparoscopy.The operative indexes,tubal patency rate,pregnancy rate and complication rate of the two groups were compared.Results In the observation group,the intraoperative blood loss(45.21+17.30)ml,operative time(62.01+4.28)min,postoperative first exhaust time(1.47+0.48)days,hospitalization time(8.81+0.98)days,but in the control group,the intraoperative blood loss(44.26+16.37)ml,operative time(61.35+5.27)min,postoperative first exhaust time(1.50+0.52)days,hospitalization time(8.69+1.07)days,there was no statistically significant difference comparing in two groups of patients with various index(P>0.05).Observation group of tubal patency rate was94.12%,the pregnancy success rate was76.47%,higher than that of control group were76.47%and56.86%.The total incidence of complications was3.92%,lower than19.61%in the control group(P<0.05).Conclusion Compared with laparoscopic surgery,laparoscopy combined with hysteroscopy is effective in the treatment of infertility,which can improve the effect of fallopian tube dredging,improve the success rate of pregnancy,and the incidence of complications is low,less traumatic,high safety.