宫腔镜联合腹腔镜手术治疗输卵管积水的效果  

Curative effect of hysteroscopy combined with laparoscopy in treatment of hydrosalpinx

作　　者：康乐 Kang Le(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院妇产科,开封475000

出　　处：《临床医学》2021年第9期19-22,共4页Clinical Medicine

摘　　要：目的探讨输卵管积水应用宫腔镜、腹腔镜联合手术治疗的临床效果。方法选择河南大学第一附属医院2018年9月至2019年9月收治的220例输卵管积水患者进行研究,纳入对象临床资料完整,确诊满足输卵管积水标准,按照随机数字表法分为观察组与对照组,每组110例。对照组患者选择腹腔镜手术治疗,而观察组患者选择腹腔镜、宫腔镜联合手术治疗。两组患者均进行1年以上随访,比较两组临床效果,以及随访1年时妊娠情况与复发率。结果观察组患者总有效率为65.45%(72/110),对照组为60.00%(66/110),两组比较差异未见统计学意义(P>0.05)。随访1年时,两组患者宫内妊娠率、异位妊娠率比较,差异未见统计学意义(P>0.05),但观察组自然宫内妊娠率高于对照组,而体外受精胚胎移植术(IVF)率低于对照组,差异有统计学意义(P<0.05);随访1年时,观察组复发率为10.00%,对照组为14.55%,两组比较差异未见统计学意义(P>0.05)。结论输卵管积水应用宫腔镜、腹腔镜联合手术治疗,相比单一腹腔镜手术方案治疗,可取得相似的临床疗效,二者宫内妊娠率、异位妊娠率、复发率相当,但联合手术方案可明显提高自然宫内妊娠率,减少体外受精胚胎移植术率。Objective To investigate the clinical efficacy of hysteroscopy combined with laparoscopy in the treatment of hydrosalpinx.Methods A total of 220 cases of hydrosalpinx patients admitted to the First Affiliated Hospital of Henan University from September 2018 to September 2019 were selected for research.The clinical data of the included subjects were complete,and the diagnosis met the criteria for hydrosalpinx.The patients were divided into observation group and control group according to the random number table,with 110 cases in each group.The patients in the control group were given laparoscopic surgery,while the patients in the observation group were given laparoscopic and hysteroscope combined surgery.Both groups were followed up for more than 1 year to compare the clinical effects of the two groups,as well as the pregnancy and recurrence rate at 1 year of follow-up.Results The total effective rate of the observation group was 65.45%(72/110),while that of the control group was60.00%(66/110),there was no significant difference between the two groups(P>0.05).During the1 year follow-up,there was no significant difference in the intrauterine pregnancy rate or ectopic pregnancy rate(P>0.05),but the natural intrauterine pregnancy rate in the observation group was higher than that in the control group,and the rate of in vitro fertilization embryo transfer(IVF)was lower than that in the control group(P<0.05).At 1 year follow-up,the recurrence rate of the observation group was 10.00%,and that of the control group was 14.55%,there was no significant difference between the two groups(P>0.05).Conclusions Hysteroscopy combined with laparoscopy in the treatment of hydrosalpinx can achieve similar clinical efficacy compared with single laparoscopic surgery.The intrauterine pregnancy rate,ectopic pregnancy rate and recurrence rate of the two are similar,but the combined surgery can significantly improve the natural intrauterine pregnancy rate and reduce the rate of in vitro fertilization and embryo transfer.

关 键 词：输卵管积水 宫腔镜 腹腔镜 妊娠率 复发率 

分 类 号：R713[医药卫生—妇产科学]