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目的探讨宫腹腔镜联合手术在输卵管性不孕中的诊治价值及不同年龄患者手术治疗效果。方法 80例输卵管性不孕症患者术前均行子宫输卵管造影术,根据输卵管梗阻部位及程度行宫腹腔镜联合下的Cook导丝插管疏通、输卵管整形伞端造口术,并同时对盆腔、宫腔内病变进行诊治。结果本组宫腹腔镜联合手术均一次完成,未发生子宫穿孔、水中毒、肠管损伤、气体栓塞等并发症;78例术后随访2a,术后妊娠率57.69%(45/78);宫腹腔镜联合手术后输卵管不同梗阻部位者妊娠率比较差异无统计学意义(P>0.05),年龄22～30岁组妊娠率(65.38%)高于>30～39岁组(39.28%)(P<0.05)。结论宫腹腔镜联合手术可作为治疗输卵管性不孕症首选方法,早诊断、早治疗可避免错过最佳育龄时间,提高妊娠率。
Objective To investigate the diagnosis and treatment value of laparoscopic combined surgery in tubal infertility and the effect of surgical treatment in patients of different ages. Methods 80 cases of tubal infertility patients underwent hysterosalpingography preoperatively, according to tubal obstruction site and degree under the Palace laparoscopic Cook guide wire catheterization, tubal plastic umbrella end ostomy, and at the same time pelvic, Intrauterine lesions for diagnosis and treatment. Results The group laparoscopic combined surgery were completed in one time, no uterine perforation, water poisoning, intestinal injury, gas embolism and other complications; 78 cases of follow-up 2a, postoperative pregnancy rate 57.69% (45/78); uterine cavity There was no significant difference in the pregnancy rates between tubal and tubal obstruction (P> 0.05). The pregnancy rate in the age group of 22-30 years (65.38%) was higher than that in the group of 30-39 years (39.28%) (P < 0.05). Conclusions Hysteroscopy combined with laparoscopic surgery can be used as the first choice for treatment of tubal infertility. Early diagnosis and early treatment can avoid missing the best age for childbearing and improve the pregnancy rate.