目的:探讨腹腔镜联合宫腔镜直视下插管疏通治疗输卵管阻塞性不孕的临床价值。方法:2009年1月～2011年1月对65例经子宫输卵管造影(hysterosalpingography,HSG)提示输卵管阻塞的不孕症患者,经腹腔镜检查确诊后对输卵管远端阻塞或积水及相应盆腔病变进行手术治疗同时在宫腔镜直视下对近端阻塞输卵管用导丝疏通治疗。结果:65例患者中经腹腔镜检查确诊有97条输卵管阻塞,其中34条近端阻塞,50条远端积水或伞端闭锁,13条近端及远端同时阻塞;手术输卵管疏通治疗后通畅92条,其中2条行输卵管吻合术。术后半年发现9例输卵管再次阻塞,半年内异位妊娠3例。结论:宫腹腔镜联合直视下导丝疏通是治疗输卵管阻塞性不孕的理想安全治疗手段,防止术后狭窄阻塞需要进一步探讨。 Objective: To investigate the clinical value of laparoscopy combined with hysteroscopy under direct vision to treat obstructive tubal infertility. Methods: From January 2009 to January 2011, 65 patients with infertility who had tubal obstruction suggestive of hysterosalpingography (HSG) were diagnosed by laparoscopy after obstruction of distal fallopian tube or water and corresponding pelvic lesions Surgical treatment of hysteroscopy under direct vision of the proximal obstruction of the fallopian tubes with guide wire dredging treatment. Results: Of the 65 patients, 97 tubal obstructions were diagnosed by laparoscopy, of which 34 were proximal obstruction, 50 were distal hydronephrosis or umbrella end closure, and 13 proximal and distal obstructions were occluded simultaneously. Surgical tubal dredging Smooth 92, of which 2 tubal anastomosis. Nine cases of tubal occlusion were found in six months after operation, and three cases of ectopic pregnancy within six months. Conclusion: The laparoscopic combined with direct wire under direct vision to clear the treatment of tubal obstruction infertility is the ideal safe treatment to prevent postoperative stricture obstruction needs further study.