摘要
目的:探讨宫腔镜与腹腔镜联合手术在诊断、治疗不孕症的价值。方法:对2000年3月～2006年5月我院的142例不孕症患者住院进行宫腔镜与腹腔镜联合检查、诊断,并视术中的不同情况而选择不同的手术方式进行相应的治疗。结果:142例中发现输卵管病变95例、盆腔粘连61例、子宫内膜异位症34例、多囊卵巢24例、子宫肌瘤5例、卵巢肿瘤6例。共实施了332项操作:双侧输卵管插管通液术142例,输卵管成形术及造口术85例,子宫内膜异位症减灭术33例,多囊卵巢打孔术24例。统计比较原发性不孕者卵巢囊肿发生率(9·30%)高于继发不孕者(2·02%),差异有显著性意义(P<0·05);壶腹部、伞部阻塞术后再通率(84·71%)明显高于间质部和峡部阻塞者(7·14%、15·00%),差异有非常显著意义(P<0·0001)。术后随访到的65例患者妊娠率为27·69%,没有输卵管阻塞者的妊娠率(45·0%)明显高于输卵管阻塞者(20·0%),差异有显著意义。结论:宫腔镜与腹腔镜联合手术能集二者之长处,同时进行宫腔、盆腔疾病的诊断与治疗,创伤小、恢复快、手术成功率高,尤其适用于输卵管远端阻塞和盆腔粘连者,是不孕症重要的检查及治疗手段。
Objective： To evaluate the clinical value of hysteroscopy combined with laparoscopy in diagnosis and treatment the patients with infertility. Methods： From March 2000 to May 2006, 142 cases with infertility were diagnosed and treated under hysteroscopy combined with laparoscopy. Results： Among the 142 cases, 95 with fallopian tube damages, 61 with pelvic adhesion, 34 with endometriosis, 24 with polycystic ovary syndrome （ PCOS）, 5 with uterine fibroma and 6 with ovary tumor. 332 procedures were performed, including 142 treatments under hysteroscopy, 85 cases by salpingoplasty or salpingotomy, 33 cases by endometriosis cytoreductive surgery, 24 cases by poly cyst ovary paracentesis. Ovarian cyst complicated with infertility had a higher rate in primarily infertility （9. 30% ） than in secondary infertility （ 2. 02% ） （ P 〈 0. 05 ） . Those that obstructed in ampullary and fimbriaend portions of fallopian tube had the better unobstruction rate （84. 71% ） after the treatment than that obstructed in interstitial and isthmus portion of the tube （7. 14%, 15% ） （P 〈0. 000 1 ） . 65 case＇s were followed after surgery and the pregnancy rate was 27.69%. Among them those without tube obstruction before surgery the pregnancy rate was 45% and those with tube obstruction was 20. 0% having signifwant difference. Conclusion： Hysteroscopy combined with laparoscopy could get the benefits of both to diagnoze and treat the damages inside uterine and pelvic cavity at same time. Which is of the important value in diagnosis and treatment of infertility, due to less trauma, quick recovery and higher success rate, especially for the patients with tube obstruction in fimbriated and ampullary potions and pelvic adhesion.
出处
《中国妇幼保健》
CAS
北大核心
2007年第13期1817-1819,共3页
Maternal and Child Health Care of China
关键词
宫腔镜
腹腔镜
联合手术
不孕症
Hysteroscopy
Laparoscopy
Combined surgery
Infertility
