Fitz-Hugh-Curtis综合征在输卵管妊娠和不孕中的发生率及其意义

EXPLORATION ON INCIDENCE OF FITZ-HUGH-CURTIS SYNDROME IN TUBAL PREGNANCY AND TUBAL INFERTILITY

目的 :了解Fitz -Hugh -Curtis综合征在输卵管妊娠和输卵管不孕中的发生率 ,探讨它们在输卵管妊娠和输卵管不孕发生中的作用。方法 :在腹腔镜检查和治疗妇科疾病时 ,确诊Fitz-Hugh -Curtis综合征遗留的典型病理改变和输卵管周围炎性病变。肿瘤、多囊卵巢综合征、子宫肌瘤等非输卵管炎性疾病患者作为对照组。结果 :在 1 0 9例输卵管妊娠患者中 ,发现慢性肝周围炎 1 5例 (1 3 .8% ) ,升结肠 -腹壁粘连 1 0例(9.2 % ) ,单纯输卵管周围炎性粘连 2 4例 (2 0 .2 % )。而在 1 1 2例对照组患者中 ,发现慢性肝周围炎患者 2例(1 .8% ) ,升结肠 -腹壁粘连患者 2例 (1 .8% ) ,输卵管周围炎性粘连患者 2例 (1 .8% )。与对照组相比 ,输卵管妊娠中肝周围炎发生率明显高于对照组 (P <0 .0 1 ) ,升结肠 -腹壁粘连发生率也高于对照组 (P <0 .0 5)。在 2 0例经腹腔镜检查诊断为输卵管不孕的患者中 ,发现肝周围炎 5例 (2 5 % ) ,未发现升结肠 -腹壁粘连。与对照组相比 ,输卵管性不孕患者中肝周围炎发生率明显高于对照组 ,差别有极显著意义P <0 .0 0 1 )。结论 :Fitz -Hugh -Curtis综合征在输卵管妊娠和不孕患者中的发生率与国外接近。肝周围炎、升结肠

Objective:To investigate the incidence of Fitz-Hugh-Curtis syndrome in patients with tubal pregnancy and tubal infertility, and to explore the importance of the syndrome in the pathogenesis of tubal pregnancy and tubal infertility. Methods:The pathologic changes of Fitz-Hugh-Curtis syndrome and salpingitis were confirmed by operative laparoscopy in patients with gynecologic disorders and recorded at the time of surgery.Results: There were 15 cases of patients with perihepatic adhesions, 10 cases of perinephritis and 24 cases of perisalpingitis among 109 cases of tubal pregnancies, whereas there were 2 cases of perihepatic adhesions, 2 cases of perinephritic adhesions and 2 cases of perisalpingitis in 112 cases of patients in the control group. The incidence of perihepatitis and perinepghritis in patients with ectopic pregnancy was 13.8% and 9.2%, respectively, much higher than that of the control's (both were 1.8%, P <0.01 and P <0.05 respectively by X 2 test). There were 5 cases of patients with perihepatic adhesions and 7 cases of patients with perisalpingitis in 20 cases of tubal infertilities. The incidence of perihepatitis in patients with tubal infertility was 25%, much higher than that of the control's ( P <0.001). No case of perinephritis was recorded in patients with tubal infertility. Conclusion:The incidence of Fitz-Hugh-Curtis syndrome in patients with ectopic pregnancy and tubal infertility is 13.8% and 25%, similar with reports of others. This demonstrates the important role of sequelae of pelvic inflammatory disease in the pathogenesis of tubal pregnancy and tubal infertility.