经阴道注水腹腔镜联合宫腔镜在不孕症诊治中的应用  

Advantage of transvaginal hydrolaparoscopy combined with hysteroscopy on diagnosis and treatment of infertility

作　　者：张丽 刘效群 李国正 杜丽荣 张亦心 吕丽华 任丽娟 田慧艳 

机构地区：[1]河北省计划生育科学技术研究院生殖中心,石家庄050071

出　　处：《生殖医学杂志》2012年第4期350-353,共4页Journal of Reproductive Medicine

基　　金：河北省人口与计划生育委员会项目(2009-B08)

摘　　要：目的探讨经阴道注水腹腔镜(THL)联合官腔镜检查在不孕症诊治中的应用价值。方法对400例术前子宫输卵管碘油造影(HSG)诊断至少有一条输卵管间质部阻塞的不孕症患者施行THL联合宫腔镜下输卵管插管术。观察THL穿刺成功率、输卵管通畅性的再评价、盆腔粘连诊断率,子宫内膜异位症(EM)诊断率、副输卵管诊断率和并发症发生率。结果 THL穿刺成功率为97.5%,对HSG诊断为间质部阻塞的输卵管联合术后再评价通畅的占86.0%,盆腔粘连诊断率为39.7%,EM诊断率为14.1%,副输卵管诊断率为5.4%,并发症发生率为1%,术后一年内的妊娠率为23.8%。结论 THL联合宫腔镜检查具有准确、微创、安全、经济等优点,可作为不孕症门诊诊治中的一线方法。Objective： To evaluate the advantage 6f transvaginal hydrolaparoscopy （THL） combined with hysteroscopy on diagnosis and treatment of infertility. Methods. Four hundreds infertile women with at lest one side fallopian tube obstruction in interstitial position received THL combined with hysteroscopy and tubal catheterization. The patients included 203 primary and 197 secondary infertile patients. The success insertion rate, pelvic endometriosis rate, para- fallopian tube rate, complication rate, and postoperative pregnancy rate within one year after treatment were observed and the fallopian tube patency was re-evaluated. Results. The success insertion rate of THL was 97.5%, the rate of pelvic adhesion 39.7%, the pelvic endometriosis rate 14.1%, the diagnosis rate of para-fallopian tube 5.4% during THL, the complications rate 1%, and postoperative pregnancy rate in one year 23.8%. The 86.0% of obstructed fallopian tube became unobstructed, which was evaluated by hysterosalipingography. Conclusions： The transvaginal hydrolaparoscopy combined with hysteroscopy is minimally invasive, safe and economical. It could provide a first-line procedure for diagnosis and treatment of infertile patient.

关 键 词：经阴道注水腹腔镜 宫腔镜检查 输卵管插管 不育 

分 类 号：R[医药卫生]