宫、腹腔镜联合诊治不孕症119例临床分析  

Clinical analysis of Diagnosis and Treatment under Hysteroscope and Celioscope to 119 infertility cases

作　　者：梁晓阳[1] 严秋林[1] 

机构地区：[1]广东省江门市妇幼保健院,广东江门529000

出　　处：《海南医学》2007年第9期18-20,共3页Hainan Medical Journal

摘　　要：目的探讨宫、腹腔镜联合检查及镜下手术诊治不孕症的临床价值。方法2002年1月至2005年6月广东省江门市妇幼保健院对119例不孕症患者进行宫、腹腔镜联合检查及镜下手术治疗,其中原发不孕41例,继发不孕78例,观察两组病例子宫及盆腔病变的发生率,术前后输卵管的通畅情况及术后妊娠率。结果119例不孕症中发现盆腔病变112例,占94.12%。慢性盆腔炎发生率最高,为51.26%,继发不孕明显高于原发不孕(p<0.01),多囊卵巢综合征的发生率原发不孕高于继发不孕(p<0.05),其余的病变有子宫内膜异位症,卵巢囊肿及生殖器结核等,两者发生率相近(p>0.05)。宫、腹腔镜检查发现子宫畸形11例,占9.24%,宫腔内病变45例,占37.82%,其中宫腔粘连发生率最高,为11.76%,其次为子宫内膜息肉及粘膜下肌瘤等,原发不孕发生率与继发不孕相近(p>0.05)。两组术后输卵管(双侧或一侧)通畅率均高于术前(p<0.05及p<0.01)。术后一年妊娠率为52.10%。结论宫、腹腔镜联合检查及镜下手术治疗可对盆腔、宫腔内病变及子宫畸形作出准确的诊断同时予以治疗,术后输卵管通畅率明显增加,妊娠率高,治疗效果好,在诊治不孕症中有明显的优越性及十分重要的临床价值。Objective To study the clinic value ol Combined Examination by Hysteroscope and Celloscope and Surgical Diagnosis and Treatment under Hysteroscope and Celioscope to infertility. Methods From January 2002 to June 2005, Combined Examination by Hysteroscope and Celioscope and Surgical Diagnosis and Treatment under Hysteroscope and Celioscope to infertility was applied to 119 infertility patients in Jiangmen Maternity and Child Care Hospital. Among these patients, 41 cases were of primary infertility, 78 cases were of secondary infertility. The pathological changes in uterus and cavity of pelvis, the openness of fallopian tube before and after the operation and the pregnancy rate after operation in both groups were observed. Results 112 among the 119 infertility cases were of pathological change in cavity of pelvis, taking 94.12%. The rate of chronic pelvic inflammatory disease was highest, taking 51.26% and the rate of secondary infertility was much higher than that of primary infertility （p〈0.01）. The rate of polycystic ovarian syndrome in primary infertility was higher than that in secondary infertility（p〈0.05）. Other pathological changes included endometriosis, cystic ovary and genital tuberculosis,etc, the rate of which were close to each other between both groups （p〉0.05）. Combined examination by hysteroscope and celioscope found 11 cases of uterine malformation, taking 94.12%, 14 cases of pathological change inside the cavity of pelvis, taking 37.82% and intrauterine adhesions was top in rate, taking 11.76%. Second were endometrial polyp and myoma in mucous membrane, etc. and the rate was close to each other between primary infertility and secondary infertility （p〉0.05）. The openness rate of fallopian tube （double or single side） in both primary infertility and secondary infertility was higher than that of before operation（p〈0.05＆ p〈0.01）and the pregnancy rate reached 52.10% within one year after the operation. Conclusions Combined examination by hysteroscope and celioscop

关 键 词：宫腔镜 腹腔镜 不孕症 妊娠 

分 类 号：R711.6[医药卫生—妇产科学]