目的　应用腹腔镜探讨不同的感染因素与输卵管性因素不孕者的盆腔病变程度的关系。方法　采用腹腔镜对 70例输卵管性不育患者的盆腔情况进行观察 ,同时进行输卵管通畅度的检查及病理检查。结果　输卵管性不孕占不孕患者的 34 .0 % ,其中生殖器结核占 47.1% ,非特异性盆腔炎 (NPI)占 5 2 .9% (P<0 .0 1) ,在输卵管完全梗阻方面 ,生殖器结核组占 80 .3% ,非特异性盆腔炎组占 5 8.1% (P<0 .0 1) ;在输卵管与外周重度粘连方面 ,生殖器结核组占 81.8% ,非特异性盆腔炎组占 36 .5 % (P<0 .0 1)。在输卵管与外周重度粘连且输卵管完全梗阻中 ,TB组为 71.2 % ,非特异性盆腔炎组为 2 1.6 % ,两组差别极显著 (P<0 .0 1)。结论　生殖器结核输卵管病理改变程度较非特异性盆腔炎明显 ;对原因不明的不孕患者应常规进行腹腔镜检查 ,尽早明确诊断 ,选择合理的治疗方案 Objective To investigate the relationship between different infection factors and the degree of pelvic lesions in patients with tubal infertility by laparoscopy. Methods Laparoscopy in 70 cases of tubal infertility pelvic conditions were observed, at the same time tubal patency and pathological examination. Results Tubal infertility accounted for 34.0% of infertility patients, of which genital tuberculosis accounted for 47.1%, non-specific pelvic inflammatory disease (NPI) accounted for 52.9% (P <0.01), tubal complete obstruction, Genital tuberculosis accounted for 80.3%, non-specific pelvic inflammatory disease accounted for 51.18% (P <0.01); tubal and peripheral severe adhesions, genital tuberculosis accounted for 81.8%, non-specific pelvic inflammatory disease group accounted for 36%. 5% (P <0. 01). In tubal and peripheral severe adhesions and tubal complete obstruction, TB group was 71.2%, non-specific pelvic inflammatory disease group was 21.6%, the difference between the two groups was extremely significant (P <0.01). Conclusions The pathological changes of genitourinary tuberculosis are more obvious than those of nonspecific pelvic inflammatory disease. Laparoscopy should be routinely performed on unexplained infertile patients, as soon as possible to confirm the diagnosis and choose a reasonable treatment plan