不育症的腹腔镜病因分析  

ANALYSIS OF THE CAUSES OF INFERTILITY BY LAPAROSCOPY

作　　者：张旭萍[1] 林金芳[1] 

机构地区：[1]上海医科大学妇产科医院

出　　处：《上海医科大学学报》1996年第6期457-460,共4页Journal of Fudan University(Medical Science)

摘　　要：探讨了腹腔镜在不育症病因诊断中的价值，旨在进一步提高不育症的腹腔镜诊断技术。１９９１年１０月至１９９５年３月采用腹腔镜肉眼检查结合美蓝输卵管通液，对３９３例不育症进行病因分析（组１）；１９９５年４月至１９９６年３月引进内凝热－色试验对８９例不育症进行病因分析（组２）。结果发现组１盆腔子宫内膜异位症１８０例，占４４．３％，盆腔炎症１２７例，占３１．３％，子宫肌腺病６例，占１．５％。美蓝加压通液对诊断输卵管炎或输卵管子宫内膜异位症及子宫肌腺病有帮助。组２盆腔子宫内膜异位症５９例，占５３．６％，盆腔炎症２８例，占２５．５％，子宫肌腺病７例，占６．４％。内凝热－色试验发现２０例镜检未能识别的子宫内膜异位症。两组中输卵管单侧或双侧不通１０９例。结论：腹腔镜肉眼检查结合美蓝输卵管通液和内凝热－色试验可提高腹腔镜对盆腔因素不育病因诊断的准确率。PURPOSE Evaluation of the value of diagnosis on causes of infertility with laparoscopy were explored,in order to further improve the technique of diagnosis of infertility with laparoscopy.METHODS Two parallel methods were used . The first one: laparoscopy combined with tubal patent test (chromotubation) with Methylene Blue were performed in 393 cases of infertility during the period from Oct.1991 to March 1995 (Group 1) . The second one: laparoscopy combined with both tubal patent test with Methylene Blue and heat-colour test were performed in 89 cases of infertility during the period from April 1995 to March 1996 (Group 2) .RESULTS There were 180 cases with endometriosis (44.3%),127 with pelvic inflammatory diseases (31.3%) and 6 with adenomyoma (1.5%)in Group 1.Tubal patent test with Methylene Blue by compression can help to diagnose salpingitis,endometriosis in tubes and adenomyoma. There were 59 cases with endometriosis (53.6%),28 with pelvic inflammatory diseases (25.5 %)and 7 with adenomyoma (6.4%)in Group 2. 20 endometriosis patients, unable to be distinguished with naked eye under laparoscopy were identified by heat-colour test. 109 cases of Group 1 and Group 2 had unilateral or bilateral tubal obstruction.CONCLUSIONS Laparoscopy combined with tubal patent test with Methylene Blue and heat-colour test can elevate the accuracy rate of the diagnosis of the causes of infertility with pelvic lesion.

关 键 词：腹腔镜 女性不育症 诊断 美蓝输卵管通液 

分 类 号：R711.604[医药卫生—妇产科学]