宫腔镜与腹腔镜联合诊治在输卵管不孕结局中的意义探讨

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目的:观察宫腔镜与腹腔镜联合诊治在输卵管不孕结局中的意义,提高输卵管不孕的临床诊治水平。方法:对2006年1月~2008年3月收治的105例输卵管不孕症患者进行宫腔镜与腹腔镜联合诊治,按输卵管病变程度分为轻、中、重度;术后随访观察3年,比较不同病变程度的妊娠结局。结果:①105例患者手术均成功,轻、中、重度患者所占比例分别为30.5%(32/105)、36.2%(38/105)、33.3%(35/105)。105例患者中盆腔粘连56例,输卵管积水32例,术后均给予抗生素预防感染5天,住院时间平均(4.5±3.2)天,无明显并发症发生。②轻、中度组妊娠成功率比较差异无统计学意义(χ2=2.134,P>0.05);轻、中度组与重度组妊娠成功率比较差异均有统计学意义(χ轻重2=15.328,χ中重2=13.427,P<0.01)。结论:宫腔镜与腹腔镜联合诊治轻、中度输卵管不孕的效果理想,但对重度输卵管不孕患者效果欠佳。 Objective: To observe the significance of hysteroscopy combined with laparoscopy in diagnosis and treatment of tubal infertility and to improve the clinical diagnosis and treatment of tubal infertility. Methods: From January 2006 to March 2008, 105 cases of tubal infertility were treated by hysteroscopy combined with laparoscopy. According to the degree of tubal disease, they were divided into mild, moderate and severe degree. The patients were followed up for 3 years, Comparison of the severity of the pregnancy outcome. Results: ① All of the 105 patients were successful in operation. The proportion of patients with mild, moderate and severe symptoms were 30.5% (32/105), 36.2% (38/105) and 33.3% (35/105) respectively. In 105 cases, there were 56 cases of pelvic adhesions and 32 cases of hydrosalpinx. All patients were given antibiotics to prevent infection for 5 days and the average length of hospital stay was (4.5 ± 3.2) days, with no obvious complication. ② There was no significant difference in the success rate of pregnancy between mild and moderate groups (χ2 = 2.134, P> 0.05). The difference of pregnancy success rates between mild and moderate groups was statistically significant (χ2 = 15.328, χ2 = 13.427, P <0.01). Conclusion: Hysteroscopy combined with laparoscopy diagnosis and treatment of mild and moderate tubal infertility results are satisfactory, but poor results in patients with severe tubal infertility.
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