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目的:观察腹腔镜治疗输卵管性不孕症的妊娠情况,并探讨盆腔粘连程度对妊娠率的影响。方法:采用回顾性研究方法,收集2008年6月～2010年4月曾经在半年内做过子宫输卵管造影提示输卵管阻塞(除外输卵管间质部阻塞者),而后在唐山市妇幼保健院行腹腔镜诊治的输卵管阻塞伴盆腔粘连性不孕症患者112例,根据术中所见将盆腔粘连程度分为轻、中、重三度,进行相应治疗及术后随访。结果:112例患者术后妊娠49例,妊娠率为43.75%,异位妊娠率为10.20%,输卵管不通伴轻度粘连的术后妊娠率为68.42%,明显高于输卵管不通伴中度粘连者(48.83%)和重度粘连者(6.45%)。结论:腹腔镜治疗输卵管阻塞伴盆腔粘连性不孕症的术后妊娠率受输卵管通畅程度及盆腔粘连程度的影响,重度盆腔粘连者应在双侧输卵管结扎后行试管婴儿辅助生育。
Objective: To observe the pregnancy status of laparoscopic treatment of tubal infertility, and to explore the effect of pelvic adhesion on pregnancy rate. Methods: A retrospective study was conducted to collect tubal hysterosalpingography (excluding tubal interstitial occlusion) from June 2008 to April 2010 in the past six months. Laparoscopy was performed in Tangshan Maternal and Child Health Hospital Diagnosis and treatment of tubal obstruction with pelvic adhesions in infertility patients 112 cases, according to intraoperative findings of pelvic adhesions into mild, moderate and severe degree, the corresponding treatment and follow-up. Results: There were 49 cases of postoperative pregnancy in 112 cases, with a pregnancy rate of 43.75% and an ectopic pregnancy rate of 10.20%. The postoperative pregnancy rate was 68.42%, which was significantly higher than those without tubal occlusion associated with moderate adhesions (48.83%) and severe adhesion (6.45%). Conclusions: Laparoscopic treatment of tubal obstruction with pelvic adhesions infertility after pregnancy rate by tubal patency and pelvic adhesions degree of impact, severe pelvic adhesions should be tubal ligation after bilateral tubal assisted fertilization.