生育镜在输卵管性不孕症诊治中的临床观察  

Clinical Application of Fertiloscopy in the Examination and Treatment of Tubal Infertility

作　　者：张丽 刘效群 李国正 杜丽荣 张亦心 吕丽华 任丽娟 

机构地区：[1]河北省计划生育科学技术研究院生殖医学中心,石家庄050071

出　　处：《国际生殖健康／计划生育杂志》2013年第3期172-174,179,共4页Journal of International Reproductive Health/Family Planning

基　　金：河北省人口与计划生育委员会项目(2009-B08);获河北医学科技一等奖(101094)

摘　　要：目的:探讨生育镜[经阴道注水腹腔镜(trasvaginal hydrolaparoscopy,THL)联合宫腔镜下输卵管插管通液术]在输卵管性不孕症诊治中的临床应用价值。方法:2010年4月—2011年3月收治经生育镜或仅行宫腔镜下输卵管插管通液术治疗的输卵管性不孕患者共232例,其中采用生育镜检查者126例(生育镜组),采用单独宫腔镜下输卵管插管通液术者106例(对照组)。观察指标:①2组患者输卵管复通率。②生育镜组THL术前未诊断而术中发现的可能影响生育力的盆腔因素。③2组手术并发症的发生率。④2组患者术后随访3,6,9个月的累积妊娠率。结果:①生育镜组和对照组输卵管复通率分别为83.8%(140/167)和85.9%(110/128),差异无统计学意义(χ2=0.25,P=0.62)。②生育镜组THL对盆腔粘连检出率为31.7%(40/126),盆腔子宫内膜异位症检出率为5.6%(7/126),输卵管系膜囊肿检出率为18.3%(23/126),副输卵管检出率为5.6%(7/126)。③生育镜组和对照组并发症发生率分别为0.8%和0%。④生育镜组3,6,9个月的累积妊娠率均高于对照组。结论:生育镜实现了宫腔镜和THL两种微创手术的优势互补,可作为不孕症门诊评价输卵管通畅性的一线方法。Objective：To investigate the clinical application of fertiloscopy in diagnosis and treatment of tubal infertility. Methods： 232 tubal infertile women who underwent fertiloscopy or hystcroscopy were selected, including 126 patients underwent fertiloscopy （fertiloscopy group）, and 106 patients underwent hysteroscopy （control group）. Parameters were included as follow： Rates of tubal patency. Factors which might affect fetility, found firstly in THL of fertiloscopy group. Rates of complations; The accumulated postoperativ pregnant rates in 3,6,9 month of following-up. Results： There was no significant difference in rates of tubal pateney between fertiloscopy group and control, 83.8% vs. 85.9% （x2=0.25,P=0.62）. The diagnosis rates by THL were, adhension 31.7%; pelvic edometriosis 5.6%; mesosalpinx cystic 18.3%; accessory fallopian tube 5.6%. Rates of complations in fertiloseopy group and control were 0.8% and 0%, respectively. The accumulate postoperativ pregnace rates in fertiloscopy group in 3,6,9 month was higher than those in control group. Conclusions：Fertiloscopy combines the advantages of two minimally invasive operations, which can be used as a first-line procedure in diagnosis and treatment of tubal infertile.

关 键 词：生育镜 阴道 腹腔镜检查 宫腔镜检查 不育 女(雌)性 输卵管疾病 

分 类 号：R711.6[医药卫生—妇产科学]