输卵管远端阻塞不孕患者腹腔镜术后妊娠情况及影响因素分析  

Influencing Factors of Postoperative Pregnancy in Distal Tubal Obstructive Infertility Patients Undergoing Laparoscopic Surgery

作　　者：陈小琴[1] 陈茜[1] 

机构地区：[1]广州市红十字会医院,广东广州510220

出　　处：《现代医院》2016年第11期1575-1577,共3页Modern Hospitals

摘　　要：目的探讨腹腔镜手术治疗输卵管远端阻塞的不孕症患者的疗效。方法选择2012年6月-2014年6月在医院妇科因输卵管远端阻塞性不孕行腹腔镜手术患者156例,术中对输卵管病变分级,术后比较不同级别输卵管妊娠情况。结果术后妊娠率Ⅰ级43.75%(7/16)、Ⅱ级37.78%(17/45)、Ⅲ级12.76%(6/47),Ⅳ级0.00%(0/26)。Ⅰ、Ⅱ级术后妊娠率明显高于Ⅲ、Ⅳ级(P<0.05)。Ⅲ、Ⅳ级中有23例术后1年未孕的患者行体外授精-胚胎移植术,妊娠率30.4%,22例行双侧输卵管结扎的患者术后行体外授精-胚胎移植术,妊娠率54.54%。根据多因素Logistic分析显示影响输卵管远端阻塞术后自然妊娠率的主要因素为:年龄、不孕年限、输卵管状态分级、是否合并输卵管积水。结论腹腔镜手术是治疗轻中度输卵管远端阻塞的有效方法;重度远端阻塞者建议输卵管结扎术后积极行体外受精-胚胎移植治疗,以获得妊娠。Objective To investigate the efficacy of laparoscopy for the treatment of patients with distal tubal ob- structive infertility. Methods A total of 156 patients with infertility caused by distal tubal obstruction who underwent laparo- scopic surgery in the hospital from June 2012 to June 2014 were selected and grading of Fallopian tubes was performed during surgery. After surgery, pregnancy situations of patients with different grades of Fallopian tubes and different therapeutic meth- ods were compared. Results During follow-up, the pregnancy rates of grade I, grade II, grade III, grade IV were respec- tively 43.75% （7/16）, 37.78% （ 17/45）, 12. 76% （6/47）, 0. 00% （0/26. The pregnancy rates of patients of grade I and grade ｜I were statistically significantly higher than those of grade III and grade IV （ P 〈 0. 05 ）. Among the patients with grade IIl and grade IV pregnancy, 23 patients underwent assisted reproduction therapy after 12 months, the pregnancy rate was 30.4%. 22 patients undergoing tubal ligation underwent assisted reproduction therapy had the pregnancy rate of 54. 54%. Logistic regression then confirmed that age, course of infertility, grading of Fallopian tubes, hydrosalpinx were ma- jor factors that affected the pregnancy outcome. Conclusion Laparoscopie surgery is an effective method for mild to moderate distal tubal obstruction. However, the severe distal tubal patient should undergo in vitro fertilization-embryo transfer （ IVF-ET ） after tubal ligation to obtain fertility.

关 键 词：输卵管远端阻塞 不孕症 腹腔镜 术后妊娠 

分 类 号：R713.7[医药卫生—妇产科学] R711.76[医药卫生—临床医学]