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目的探讨经阴道注水腹腔镜联合宫腔镜检查对不孕症患者生育能力的评估价值。方法选取该院2014年1月-2016年3月收治的经阴道注水腹腔镜联合宫腔镜检查的不孕症患者100例,按照患者的发病机制将其分为继发性不孕组(48例)和原发性不孕组(52例),两组患者均实施经阴道注水腹腔镜联合宫腔镜检查后,比较两组患者检查所需时间、盆腔病变情况、输卵管通畅性、穿刺成功率、术后并发症发生情况和离院时间等指标。结果 100例患者中,腔镜成功进入患者子宫直肠陷凹者96例(96.0%);继发性不孕组中术后输卵管通畅者14例,显著低于原发性不孕组(P<0.05)。继发性不孕组患者中盆腔粘连患者30例,显著多于原发性不孕组者14例(P<0.05);而两组子宫内膜异位症与输卵管系膜囊肿例数比较,差异无统计学意义(均P>0.05)。患者实施经阴道注水腹腔镜检查所需要的平均时间为(10.4±1.8)min,而经阴道注水腹腔镜联合宫腔镜检查所需要的时间则为(32.3±4.5)min,在完成手术后的离院时间为(87.5±12.2)min,手术结束后患者阴道壁穿刺孔的愈合时间则为(4.6±0.4)d。两组患者均无术后出血的情况发生,并且没有直肠损伤和盆腔感染等不良情况出现。结论经阴道注水腹腔镜联合宫腔镜检查对不孕症患者生育能力的评估具有较高的准确性。
Objective To evaluate the value of transvaginal laparoscopy combined with hysteroscopy in the evaluation of fertility in infertile patients. Methods A total of 100 infertility patients who underwent transvaginal laparoscopy combined with hysteroscopy admitted from January 2014 to March 2016 in our hospital were divided into secondary infertility group (48 Cases) and primary infertility group (52 cases). The patients in both groups received laparoscopic transvaginal laparoscopy combined with hysteroscopy to compare the time required for examination, pelvic lesions, tubal patency, successful puncture Rate, postoperative complications and departure time and other indicators. Results Of the 100 patients, 96 cases (96.0%) were successfully entered the uterus and rectum, and 14 cases of postoperative tubal patency in the secondary infertility group were significantly lower than those of the primary infertility group (P < 0.05). There were 30 cases of pelvic adhesions in secondary infertility group, which were significantly more than 14 cases of primary infertility group (P <0.05); while the two groups of endometriosis and tubal mesmporal cyst number, The difference was not statistically significant (all P> 0.05). The average time required for laparoscopy in patients receiving transvaginal water instillation was (10.4 ± 1.8) min, whereas the time required for transvaginal laparoscopy combined with hysteroscopy was (32.3 ± 4.5) min. After the procedure was completed The time of leaving hospital was (87.5 ± 12.2) min, and the healing time of perforation of vaginal wall was (4.6 ± 0.4) d after operation. No postoperative bleeding occurred in both groups, and no adverse reactions such as rectal injury and pelvic infection occurred. Conclusion Transvaginal laparoscopic combined with hysteroscopy in infertility patients with fertility evaluation with high accuracy.