腹腔镜诊断不孕症病因分析

Application of Operative Laparoscopy on Infertile "Patients.

目的:应用腹腔镜诊断技术检查不孕症患者的盆腔情况,了解导致不孕的原因,同时评价腹腔镜诊断技术在 不孕症中的应用价值。方法:使用德国WISAP电视腹腔镜对603例不孕症患者进行盆腔检查,并经宫腔灌注稀释美 兰液了解输卵管通畅情况。结果:在603例不孕症患者中,95.19％查出异常情况,前3位依次为输卵管阻塞 (66.17％)、盆腔粘连(62.02％)、子宫内膜异位症(37.48％)。其中,原发不孕与继发不孕组间有差异。原发不孕组 的生殖器发育异常,盆腔结核较继发不孕组突出,盆腔正常者亦多于继发不孕组。而继发不孕组的盆腔粘连、输卵管 阻塞、子宫肌瘤的发生则高于原发不孕组。结论:应用腹腔镜诊断技术对不孕症患者进行盆腔检查,能够及时发现导 致不孕的原因,特别是一般临床检查容易漏诊的轻型子宫内膜异位症、输卵管发育异常等,对根据病情选择合适的治 疗方案,同时对预后做出判断均具有十分重要的价值。

Objective: To evaluate the effects of operative laparoscopy on the pelvic examination of infertile .patients and the diagnosis of infertility. Methods; The examination of the pelvis and the oviduct by infusing diluted Methylthionium Chloride Injection into uterus were performed by using operative laparoscopy in 603 infertile patients. Results: The abnormal rate was 95. 19% including oviduct obstruction (66. 17% ) , pelvic conglutination (62. 02% ) and endometriosis (37.48% ) in 603 infertile patients. The genitalia abnormality, pelvic tuberculosis and the number of pelvic normality of primary infertile patients were higher than those of subsequent infertile patients. However, the rates of pelvic conglutination, oviduct obstruction and u-terine sarcoma of primary infertile patients were lower than those of the subsequent infertile patients. Conclusions: The reasons of infertility, especially some light endometriosis and oviduct abnormality which can not be examined by general methods can be found by laparoscopy. Furthermore, laparoscopy is propitious to select treatment protocols and estimate the prognosis of infertile patients.