腹腔镜诊治输卵管性不孕58例临床分析

Laparoscopic Diagnosis and Treatment of Tubal Infertility:Clinical Analysis of 58 Cases

目的 :探讨和评价腹腔镜技术在输卵管性不孕应用中的诊断及治疗价值。方法 :于腹腔镜下对 5 8例怀疑输卵管不孕患者进行诊治 ,直视下观察不孕症患者盆腹腔脏器变化 ,并进行输卵管病变的矫治 ,同时行输卵管通液术。结果 :5 8例不孕症患者中慢性盆腔炎占 5 1.7% ,子宫内膜异位症占 2 9.3 % ,多囊卵巢综合征占 8.6% ,盆腔结核占 6.9% ,正常盆腔占 3 .5 %。术后 1年内妊娠率为 3 4 .5 %。腹腔镜下输卵管美蓝通液与 HSG比较总的符合率 88.8% ,腹腔镜检明显优于 HSG(P<0 .0 1)。结论 :腹腔镜技术在输卵管性不孕治疗中融诊断及治疗于一体 ,较准确判断输卵管的结构与功能 ,具有创伤小、术后恢复快等优点。

Objective: To investigate the diagnostic value and effectiveness of treatment with laparoscopy in patients with tubal infertility. Methods: 58 patients with doubtful tubal infertility were selected and studied under laparoscopy. The morphological appearance of pelvic in infertility patients was observed and the hydrotubation was performed at the same time under laparoscopy.Results: Among of 58 cases with tubal infertility, chronic pelvic inflammatory disease occupied 51 7%, endomtriosis occupied 29 3%, polycystic ovary syndrome occupied 8 6%; pelvic tuberculosis occupied 6 9%, normal pelvic cavity occupied 3 5%. The pregnancy rates after operation was 34 5% in a follow up time of one year. According to the findings by laparoscopy, hysterosalpingography(HSG) diagnosis was correlated well in 88 8% of cases. Laparoscopic examination was more accurate than that of HSG ( P <0 01). Conclusion:Laparoscopic examination can judge accurately the tubal fabric and function and combine diagnosis with treatment.It is a minimal invasive surgery that can shorten the recover time of patients after operation. Laparoscopy appears to be a valuable way to improve the accuracy of diagnosis and effectiveness treatment of tubal infertility.