腹腔镜下盆腔重度粘连分解程度对术后妊娠的影响  

Effects of the extent of laparoscopic adhesiolysis on pregnancy rates in infertile women with severe adhesions

作　　者：左焕荣[1] 

机构地区：[1]天津市计划生育研究所,300131

出　　处：《中国计划生育学杂志》2013年第5期328-330,共3页Chinese Journal of Family Planning

摘　　要：目的:探讨腹腔镜下盆腔重度粘连分解程度对术后妊娠的影响。方法:将因输卵管性不孕而行腹腔镜手术,术中探查为重度粘连且输卵管远端梗阻的328例患者,随机分为观察组和对照组。观察组分解卵巢及输卵管周围粘连,尽量暴露卵巢、游离输卵管壶腹部及伞端即可;对照组充分松解粘连,尽量恢复子宫、输卵管及卵巢的解剖结构,其余处理两组相同,观察术中、术后情况及妊娠率。结果:观察组患者手术时间短、出血少、并发症少、住院时间短,术后宫内妊娠率与对照组无差异(P>0.05),而异位妊娠发生率低于对照组。结论:对于远端输卵管梗阻导致不孕的患者,腹腔镜下行盆腔粘连松解术疗效明确,但重度粘连松解程度应权衡利弊,强调暴露卵巢及游离输卵管壶腹部及伞端即可。Objective ： To evaluate the effects of the extent of laparoscopic adhesiolysis on the pregnancy rate in infertile women with severe adhesions. Methods： A total of 328 women suffering from distal tubal obstruction due to severe pelvic adhesions were randomly divided into the treatment and the control groups. In the treatment group, a limited elective laparoscopic adhe- siolysis was performed, in which the working space focused on the fimbria of oviduct and ovary. While in the control group, a thoroughly laparoscopic adhesiolysis was performed in order to restore anatomic structures as near normal as possible. Results： There was no statistically significant difference in the pregnancy rate between the treatment group and the control group. But the incidence of ectopic pregnancy in the treatment group was significant lower than that of the control group. Conclusion ： Lap-aroscopic adhesiolysis may be an effective treatment in female infertility associated with severe adhension. The area of adhesi- olysis should be focused on fimbrial and ovarian areas.

关 键 词：腹腔镜 重度粘连 松解术 不孕症 妊娠率 

分 类 号：R713[医药卫生—妇产科学]