368例输卵管远端阻塞性不孕症患者腹腔镜诊治及疗效分析  

Analysis of the Efficacy of Laparoscopy for the Diagnosis and Treatment of 368 Patients with Distal Tubal Obstructive Infertility

作　　者：周未艾 

机构地区：[1]湖南省常德市妇幼保健院妇科,湖南常德415700

出　　处：《医学临床研究》2012年第7期1305-1307,共3页Journal of Clinical Research

摘　　要：【目的】探讨腹腔镜手术治疗输卵管阻塞性不孕症患者疗效。【方法】选择经子宫输卵管碘油造影（HSG）诊断输卵管远端阻塞的不孕患者418例，其中腹腔镜确诊的不孕患者368例，按不孕原因分为原发性不孕组（n=148）和继发性不孕组（n=220），所有患者均行腹腔镜诊治，比较HsG发生率诊断与腹腔镜诊断输卵管通畅性的准确率及两组腹腔镜治疗后盆腔合并症发生率及术后妊娠率。【结果】两组患者合并盆腔粘连无统计学意义（P〉0．05），但原发性不孕组合并多囊卵巢及子宫内膜异位症发生率高于继发性不孕组，差异有统计学意义（P〈0．05）；两组患者术后3个月、6个月、12个月宫内妊娠率比较差异均无统计学意义（P〉0．05），但继发性不孕组治疗24个月时宫内妊娠率高于原发性不孕组，差异有统计学意义（P〈0．05）。【结论】经腹腔镜下准确诊断输卵管远端阻塞性不孕患者，积极行腹腔镜疏通不畅处，疗效满意，值得临床推广应用。[Objective] To explore the efficacy of laparoscopy for the treatment of patients with tubal ob- structive infertility. [Methods]Totally 418 patients with distal tubal obstructive infertility diagnosed by hyste- rosalpingography（HSG） and 368 patients with infertility confirmed by laparoscopy were chosen. According to the causes of infertility, all patients were divided into primary infertility group and secondary infertility group. All patients underwent laparoscopy for the diagnosis and treatment. The accuracy of HSG and laparoscopy for the diagnosis of tubal patency, the incidence of pelvic complications of pelvis and postoperative pregnancy rate were compared between two groups. [Results] There was no significant difference in the incidence of pelvic adhesion between two groups（ P 〉0.05）. The incidence of polycystic ovary and endometriosis in primary in- fertility group was higher than that in secondary infertility group（ P 〈0.05）. There was no significant differ- ence in intrauterine pregnancy rate 3, 6 and 12 months after the operation between two groups（ P 〈0.05）. But intrauterine pregnancy rate at 24 months in secondary infertility group was higher than that in primary in- fertility group, and there was significant difference rate（ P 〈0. 05）. [Conclusion] Laparoscopy for the correct diagnosis of patients with distal tubal obstructive infertility and the active treatment of the obstructive site has satisfactory efficacy, so it is worthy of clinical promotion.

关 键 词：不育 女(雌)性/诊断 输卵管阻塞/诊断 腹腔镜检查 外科手术 腹腔镜 

分 类 号：R711.6[医药卫生—妇产科学]