应用腹腔镜及阴道B超检测不孕因素的探讨  

AProspectiveStudyonCausalFactorsofFemaleInfertilitywithLaparoscopyandtransvaginalB┐ultrasound

作　　者：顾玲芬[1] 张丽珠[1] 顾方颖[1] 王泽密[1] 耿力[1] 

机构地区：[1]北京医科大学第三临床医学院妇产科

出　　处：《中华妇产科杂志》1996年第1期18-21,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：分析女性不孕的因素。方法：对８５例不孕妇女进行阴道Ｂ超检测卵泡发育、排卵，并于排卵后２～６天行腹腔镜检查。结果：阴道Ｂ超检测卵泡发育类型有６种，分别为正常卵泡排卵４８例（５６．４７％）；双卵泡排卵５例（５．８８％），卵泡大（与正常卵泡比较）；小卵泡排卵１４例（１６．４７％），卵泡小，排卵迟，发育速度慢；卵泡不破裂黄素化综合征（ＬＵＦＳ）６例（７．０６％），卵泡大；多囊卵巢排卵３例（３．５３％），卵泡小，排卵晚；无排卵月经９例（１０．９０％）。腹腔镜检查发现，子宫内膜异位症（ＥＭＳ）３６例（４２．３５％），盆腔结核１７例（２０．００％），盆腔粘连３０例（３５．２９％），输卵管不通和不畅２８例（３２．９４％），ＥＭＳ患者输卵管大都通畅，排卵者因粘连包裹未见血体及排卵斑的假ＬＵＦＳ６例。结论：卵泡发育与不孕有关，盆腔结核仍为不孕的主要原因。Objective:TostudythecausalfactorsoffemaleinfertilitywithlaparoscopyandB-ultrasound.Methods:Eighty-fiveinfertilewomenwereevaluatedbyserialtransvaginalB-ultrasoundscansforfoliculardevelopmentandovulationandbylaparoscopicexaminations2to6daysafterovu-lation.Results:ThepatternsoffoliculardevelopmentandovucatingdetectedbyB-ultrasoundwere:(1)ovulationfromnormalfolicle(ONF)(56.47%);(2)ovulationfromtwofoliclesatthesametime(O2F)(5.88%);(3)ovulationfromsmalfolicle(OSF)(16.47%);(4)ovulationfrompoly-cysticovaries(PCO)(3.53%);(5)luteinizedunrupturedfoliclesyndreome(LUFS)(7.06%);(6)anovulation(10.90%).Laparoscopicexaminationsshowedthattheincidenceofpartialandcompletetubalobstructionwas32.94%andpelvicadhesions35.29%.Pelvictuberculosiswasfoundin20.00%,whichwasthemaindiseaseleadingtopelvicadhesions(46.67%),andtubalobstruction(60.71%).Endometriosis(EMS)wasdiscoveredin36cases(42.35%),amongthem,30(83.33%)hadpatenttubes.Thestigmasor/andcorpushemorrhagicawereseenin60outof70patientsinwhomovulationhadbeendiagnosedbyB-ultrasound.6casesweredefinedas“mechanicalyunrup-turedfoliclesyndrome”.Conclusions:Anbnormalfoliculardevelopmentmayresultinfemaleinfer-tility.Pelvictuberculosisisanothermaincausalfactorofinfertility.Endometriosisrelatedinfertilitymayratherresultfromotherfactorsthantubalobstruction.LaparoscopicexaminationscombinedwithtransvaginalB-ultrasoundscamsareveryusefulapproachesintheetiologicalstudyoffemalein-fertility.

关 键 词：阴道 腹腔镜 不孕症 超声波诊断 

分 类 号：R711.602[医药卫生—妇产科学]