宫腔镜代输卵管镜应用于评价输卵管积水黏膜状况  

Evaluation of Tubal Mucosal Status Using Hysteroscopy in Patients with Hydrosalpinx

作　　者：周巧云[1] 黄晓武[1] 

机构地区：[1]首都医科大学附属复兴医院宫腔镜中心,北京100038

出　　处：《国际生殖健康／计划生育杂志》2017年第3期195-198,共4页Journal of International Reproductive Health/Family Planning

基　　金：首都临床特色应用研究(Z141107002514118)

摘　　要：目的:探讨宫腔镜代输卵管镜对输卵管积水黏膜状况评价的应用价值。方法:选择2013年1月-2015年12月因一侧或双侧输卵管积水在首都医科大学附属复兴医院行腹腔镜下输卵管整形术的不孕患者64例,术中应用宫腔镜代输卵管镜对输卵管积水壶腹部黏膜进行评分,同时应用美国生育学会修订(r-AFS)的附件粘连分期系统针对附件进行评分,随访6~42个月,失访4例。结果:60例患者中有18例自然宫内妊娠,其中16例宫腔镜代输卵管镜评估为Ⅰ级,妊娠率66.7%(16/24),2例评估为Ⅱ级,妊娠率12.5%(2/16);宫腔镜代输卵管镜评分Ⅰ级患者的自然妊娠率与Ⅱ级患者比较差异有统计学意义(Fisher精确检验P=0.003)。18例的r-AFS评分为Ⅰ、Ⅱ、Ⅲ期者中分别为8、4、6例患者自然妊娠,差异无统计学意义(χ~2=1.905,P=0.442)。结论:宫腔镜代输卵管镜对输卵管积水患者输卵管积水壶腹部黏膜状态的评分与妊娠结局之间有一定的相关性,对临床治疗方案的选择有一定指导意义。Objective：To evaluate the tubal mucosal status using hysteroscopy as a succedaneum of salpingoscopy in those patients with hydrosalpinx.Methods：A total of 64 infertility patients who underwent laparoscopic tubal anaplasty due to unilateral or bilateral tubal hydrosalpinx were recruited between January 2013 to December 2015.Hysteroscopy was used as a succedaneum of salpingoscopy to evaluate the mucosa of the tubal ampulla,while the r-AFS staging system was also used.The patients were followed up for 6 to 42 months after surgery.Four cases were lost in follow-up.Results：Among the 60 patients,18 cases got natural intrauterine pregnancy.Among them,16 cases were classified as grade Ⅰ,with the pregnancy rate 66.7%（16/24）：2 cases were classified as grade Ⅱ,with the pregnancy rate 12.5%（2/16）.There was a significant difference in the rate of natural intrauterine pregnancy between the grade Ⅰgroup and the grade Ⅱgroup（P=0.003）.There were 8,4 and6 patients who got their natural intrauterine pregnancy in the r-AFS′ s grade Ⅰ,Ⅱ and Ⅲ group,respectively.There is no correlation between the rate of natural intrauterine pregnancy and the r-AFS′s score（χ-2=1.905,P=0.442）.Conclusions：There is a significant correlation between the score evaluated by hysteroscopy as a succedaneum of salpingoscopy with the pregnancy outcome,suggesting that this is a alternative clinical method.

关 键 词：内窥镜检查 宫腔镜检查 输卵管炎 输卵管 黏膜 输卵管镜 

分 类 号：R711.6[医药卫生—妇产科学]