不孕症患者输卵管积液经腹腔镜实施输卵管造口进行治疗的临床研究

Clinical study on laparoscopic tubal salpingostomy in treatment of infertile patients with hydrosalpinx

目的:分析应用腹腔镜实施输卵管造口治疗不孕症并输卵管积液的临床疗效。方法:将60例不孕症并输卵管积液患者根据积液量分为小量组(积液直径<3 cm,患者33例)和大量组(积液直径≥3 cm,患者27例),对比两组的临床治疗效果。结果:两组手术时间、术中出血量及术后下床时间比较未见统计学差异(t=0.012 1,P=0.495 1;t=0.091 1,P=0.463 8;t=-0.394 4,P=0.347 3)。术前两组患者白细胞介素2(IL-2)和白细胞介素10(IL-10)比较未见统计学差异,治疗后两组患者IL-2和IL-10均显著改善,但小量组较大量组改善更为明显(t=-32.029 7,P=0.000 0;t=97.634 9,P=0.000 0)。同时在随访1年的时间内,小量组妊娠率明显高于大量组(χ2=5.725 1,P=0.016 7),且小量组妊娠成功患者的妊娠平均时间为(5.78±1.13)月,明显短于大量组妊娠成功患者的妊娠平均时间(7.22±1.25)月(t=-2.958 4,P=0.003 2)。结论:腹腔镜实施输卵管造口治疗不孕症并小量输卵管积液的疗效明显优于不孕症并大量输卵管积液。

Objective: To analyze the clinical efficacy of laparoscopic tubal salpingostomy in treatment of infertile patients with hydrosalpinx. Methods: Sixty infertile patients with hydrosalpinx were divided into small- volume group( diameter of hydrosalpinx < 3 cm,33 patients) and large- volume group( diameter of hydrosalpinx≥3 cm,27 patients) according to the volume of hydrosalpinx; the clinical curative effects in the two groups were compared. Results: There was no statistically significant difference in operation time,amount of intraoperative blood loss and postoperative bed time between the two groups( t = 0. 012 1,P = 0. 495 1; t = 0. 091 1,P = 0. 463 8; t =- 0. 394 4,P = 0. 347 3). Before operation,there was no statistically significant difference in the levels of interleukin- 2 and interleukin- 10 between the two groups; after operation,the levels of interleukin- 2 and interleukin- 10 in the two groups increased,especially in small- volume group( t =- 32. 029 7,P = 0. 000 0; t = 97. 634 9,P = 0. 000 0). The pregnancy rate in small- volume group was statistically significantly higher than that in large- volume group within one year after operation( χ2= 5. 725 1,P = 0. 016 7),the mean pregnancy time in small- volume was( 5. 78 ± 1. 13) months,which was statistically significantly shorter than that in large- volume group( 7. 22 ± 1. 25months)( t =- 2. 958 4,P = 0. 003 2). Conclusion: The curative effect of laparoscopic tubal salpingostomy in treatment of infertility combined with small- volume hydrosalpinx is superior to infertility combined with large- volume hydrosalpinx.