腹腔镜在诊治女性不孕症中的应用

The application of laparoscopy on the diagnosis and treatment of female infertility

目的 :评价腹腔镜诊治女性不孕症的价值。方法 :回顾分析腹腔镜检查治疗女性不孕症 1 0 0例的临床资料。结果 :腹腔镜检查示盆腔器质性病变 95例 ,检查阳性率为 95 % ,其中输卵管炎 4 1例 ,盆腔粘连35例 ,子宫内膜异位症 1 3例 ,多囊卵巢综合征 4例 ,盆腔结核 2例。输卵管炎、盆腔粘连为引起不孕症的主要病因 ,其次为子宫内膜异位症、多囊卵巢综合征。子宫输卵管造影与腹腔镜下输卵管通液存在假阳性、假阴性 ,两者总符合率达 80 %。经腹腔镜手术输卵管复通率达 91 6 7%。结论 :应用腹腔镜技术能早期明确女性不孕的盆腔原因 ,腹腔镜直视下输卵管美蓝通液能准确地观察输卵管的通畅度、形态及功能 ,并能准确地施行针对性治疗 ,为术后治疗指明方向 ,提高了输卵管复通率及不孕症患者的受孕率。

Objective:To evaluate the laparoscopy in the diagnosis and treatment of female infertility.Methods:One hundred patients with female infertility operated by laparoscopy were analyzed.Results:In these patients 95 cases had pelvic disease,the positive rate 95%(95/100),41 cases in salpingitis,35 cases in pelvic adhesion,13 cases in endometriosis,4 cases in polycystic ovary syndrome,and 2 cases in pelvic tuberculosis.Salpingitis and pelvic adhesion were the major causes of female infertility.The second causes were endometriosis and polycystic ovary syndrome.There was false positive and negative value of salping hysterography and hydrotubation by laparoscopy,appropriate for them was 80%.The repatency of tubal after laparoscopic surgery was 91.67%.Conclusions:Laparoscopy can earlier find out the cause of infertility caused by pelvic disease.Hydrotubation with Metylene Blue under laparoscopy can investigate the shape and the patency of fallopian tube more exactly than other methods and provide timely therapy and improve the rate of repatency of tubal and pregnancy of female infertility.Laparoscopic surgery is an efficient method to diagnose and treat female infertility up to now.