宫腔镜联合腹腔镜诊治女性不孕症61例临床分析

Clinical analysis of hysteroscopy combined with laparoscopy in the diagnosis and treatment of 61 cases female infertility

目的 探讨宫腔镜联合腹腔镜诊治女性不孕症的临床价值。方法 回顾性分析2014年1月至2019年7月于本院行宫腔镜联合腹腔镜诊治的61例不孕症患者的临床资料,分析不孕原因、输卵管通畅情况及术后妊娠情况。结果 61例不孕症患者中原发性不孕症15例,占24.59%,继发性不孕症46例,占75.41%。女性不孕症的主要原因是慢性盆腔炎(52.46%)、子宫内膜异位症(22.95%)和子宫内膜息肉(11.48%)。慢性盆腔炎症是导致女性继发不孕的主要原因,占60.87%(28/46);子宫内膜异位症是导致女性原发不孕的主要原因,占40.00%(6/15)。61例不孕症患者输卵管通畅59条,通而不畅31条,输卵管阻塞32条。61例不孕症患者术后自然妊娠率为44.26%(27/61);15例原发性不孕患者,妊娠成功率为46.67%;46例继发性不孕患者,妊娠成功率为43.48%。结论 宫腔镜联合腹腔镜能快速明确女性不孕的原因及部位,并采取针对性治疗,对诊治女性不孕症具有重要临床价值。

Objective To explore the clinical value of hysteroscopy combined with laparoscopy in the diagnosis and treatment of female infertility.Methods The clinical data of 61 patients with infertility who underwent hysteroscopy combined with laparoscopy in our hospital from January 2014to July 2019 were retrospectively analyzed, and the causes of infertility, tubal patency and postoperative pregnancy were analyzed. Results Among the 61 cases of infertility, 15 cases were primary infertility, accounting for 24.59%, and 46 cases were secondary infertility, accounting for 75.41%.The main causes of female infertility were chronic pelvic inflammatory disease(52.46%), endometriosis(22.95%) and endometrial polyps(11.48%).Chronic pelvic inflammation was the main cause of female secondary infertility, accounting for 60.87%(28/46);endometriosis was the main cause of female primary infertility, accounting for 40.00%(6/15). In 61 cases of infertility patients, 59 fallopian tubes were unobstructed, 31 were blocked,and 32 fallopian tubes were blocked. The postoperative natural pregnancy rate of 61 infertile patients was 44.26%(27/61);the pregnancy success rate of 15 primary infertility patients was 46.67%;the pregnancy success rate of 46 secondary infertility patients was 43.48%. Conclusion Hysteroscopy combined with laparoscopy can quickly identify the causes and location of female infertility, and take targeted treatment, which is of great clinical value in the diagnosis and treatment of female infertility.