经阴道注水腹腔镜在盆腔疾病诊治中的应用  

Clinical application of transvaginal hydrolaparoscopy in diagnosis and treatment for pelvic disease

作　　者：邹敏[1] 叶萍 胡小良[3] 吕晓亮[1] 张秀果[1] 潘红平 

机构地区：[1]广东医学院附属东莞市厚街医院妇产科,广东东莞523960 [2]东莞市中堂医院,广东东莞523960 [3]广东省暨南大学第二临床医学院,广东深圳518020

出　　处：《中国计划生育和妇产科》2009年第3期32-36,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：广东省卫生厅医学科学技术研究基金（A2008799）

摘　　要：目的探讨经阴道注水腹腔镜（transvaginal hydrolaparoscopy，THL）在盆腔疾病诊治中的临床效果和安全性。方法选择盆腔疾病患者70例进行THL检查，记录检查和治疗结果、后穹隆穿刺成功率、转行经腹腔镜（standard diagnostic laparoscopy，LAP）率、与LAP比较的诊断符合率、并发症发生率、手术时间、门诊留观时间、手术费用等。结果检查发现盆腔异常47例、术中经输卵管通液术或宫腔镜下输卵管口插管通液术疏通阻塞输卵管10例、治愈输卵管妊娠7例；穿刺成功率为91．4％；THL转LAP率34．3％，THL与LAP诊断符合率为93．3％；THL手术并发症1．4％。结论THL在盆腔疾病检查中，能提供与L心准确度相似的结果，可作为盆腔疾病的早期检查手段，对不严重的盆腔疾病可进行简单的操作和治疗。THL操作简单、准确、安全、微创、经济、患者易接受，有较好的应用前景。Objective To explore the clinical efficacy and safety of transvaginal hydrolaparoscopy （THL） in the diagnosis and treatment of pelvic disease. Methods 70 patients with pelvic disease were examined by ransvaginal hydrolaparoscopy. The pelvic pa- thology and therapeutic outcomes, successful rate of inserting into the pouch of Douglas, the rate of conversion to transabdominal lapa- roscopy, the matched diagnosis rate compared with transabdominal diagnostic laparoseopy, and complication were recorded, operative time, discharge time and cost were also observed. Results There was 47 cases of pelvic abnormality, 10 cases after the tubal patent test or the dye - test using catheterization of the tubal ostium by hysteroscopy and 7 cases of tubal pregnancy cured by THL. The suc- cessful rate of inserting into the pouch of Douglas was 91.4% and the rate of conversion to transabdominal laparoscopy was 34.3%, at the same time, the rate of matched diagnosis was 93% between THL and LAP. The incidence of complication of THL was 1.4%. Conclusion It was the similar accuracy with laparoseopy and could be an early method of diagnosis and a simple treatment in pelvic disease of THL. It would be a valuable technique for the diagnosis and treatment in pelvic disease of THL.

关 键 词：不育 女性 妊娠 输卵管 经阴道注水腹腔镜检查 腹腔镜检查 

分 类 号：R711.6[医药卫生—妇产科学]