继发不孕症120例在腹腔镜下的表现及其病因分析  

Analysis of 120 Female Patients with Secondary Infertility After Laparoscopy and the factors

作　　者：侯桂玉[1] 梁美燕[1] 

机构地区：[1]广东省佛山市顺德区第一人民医院妇产科,528300

出　　处：《中国医药指南》2010年第12期17-19,共3页Guide of China Medicine

摘　　要：目的应用腹腔镜诊断技术探讨继发不孕症的病因变迁,评价腹腔镜对继发不孕症的诊断价值。方法应用腹腔镜对120例继发不孕症妇女的盆腔疾病和不孕的影响因素进行分析。结果腹腔镜检查发现盆腔器质性病变116例,检查阳性率为96.67%。慢性盆腔炎、盆腔粘连和子宫内膜异位症是引起继发不孕的主要盆腔疾病,占继发不孕的88.33%。慢性盆腔炎、盆腔粘连是继发不孕症的第一位病因,占51.67%(62/120);子宫内膜异位症是第二位病因,占36.67%(44/120)。慢性盆腔炎、盆腔粘连患者中87.10%有一侧或双侧输卵管梗阻;子宫内膜异位症患者中仅22.73%有输卵管梗阻。慢性盆腔炎、盆腔粘连者多无急性盆腔炎病史,61.29%(38/62)没有自觉症状。结论生殖道炎症和节育手术引起盆腔感染是继发不孕的重要原因,且以亚临床感染为主,应引起临床高度重视。应用腹腔镜技术对继发不孕症的病因诊断有重要价值,对继发不孕的盆腔疾病分出亚类,便于针对性地治疗,并可在直视下通液,动态观察输卵管通畅度和形态。Objective To investigate the cause of secondary infertility and evaluate the diagnostic value of laparoscopy in disgnosis of secondary infertility. Methods The relationship between pelvic disease and secondary infertility in 120 female patients with laparoseopy was analyzed. Results 114 of 120 cases with secondary infertility （96.7%） had pelvic diseases.Pelvic inflammatory disease/pelvic adhesions and endometriosis were major causes resulting in secondary infertility, approximately 88.3%.The first cause of secondary infertility was pelvic inflammatory disease/pelvic adhesions（51.7%）and the second was endometriosis（36.7%）.There were 88.3% patients with pelvic inflammatory disease/pelvic adhesions and 31.8% with endometriosis presented fallopian obstruction. Most of the patients with pelvic inflammatory disease/pelvic adhesions didn＇t have history of acute process and 61.3% were asymptomatic. Conclusion Genital inflammatory disease and operation concerning conception control are the important causes of secondary infertility which deserve to be drawn attention. The important value of laparoscopy in diagnosis secondary infertility is that it could definite the pelvic cause, direct treatment and investigate the shape and the patent degree of fallopian under the direct dynamic observation by hydrotubation.

关 键 词：腹腔镜 继发不孕症 盆腔疾病 病因 

分 类 号：R711.6[医药卫生—妇产科学]