138例造影输卵管迂曲上举不孕症患者宫、腹腔镜诊治结果分析  

Analysis of Diagnosis and Treatment Results of Hysteroscopy Combined With Laparoscopy in 138 Cases of Infertility With Tortuous and Vertical Fallopian Tube Under Hysterosalpingography

作　　者：黄彦文 李留霞[1] 郭瑞霞[1] 朱迎[1] 张艳艳[1] 刘艳芳 宋若玲 Huang Yanwen;Li Liuxia;Guo Ruixia(Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China)

机构地区：[1]郑州大学第一附属医院妇产科,郑州450052

出　　处：《中国微创外科杂志》2022年第1期35-39,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：河南省医学适宜技术推广项目(SYJS2020107)。

摘　　要：目的探讨子宫输卵管造影(hysterosalpingography,HSG)显示输卵管迂曲上举的不孕症患者宫、腹腔镜联合手术的诊治价值。方法对2015年3月~2019年3月因不孕症行HSG检查显示输卵管迂曲上举并接受宫、腹腔镜联合手术138例的临床资料进行回顾性分析。结果宫、腹腔镜联合检查发现盆腔异常89.1%(123/138),以盆腔粘连最为常见(87.0%,120/138)。术后自然妊娠率73.2%(101/138),其中宫内妊娠率68.1%(94/138),异位妊娠率5.1%(7/138),活产率60.9%(84/138)。绝大部分妊娠[85.1%(80/94)]在术后1年内发生。结论HSG显示输卵管迂曲上举的不孕症患者多合并盆腔粘连等导致不孕的因素,宫、腹腔镜联合手术能取得较好的治疗效果,多数于术后1年内妊娠。Objective To explore the diagnosis and treatment value of hysteroscopy combined with laparoscopy in infertility patients with tortuous and vertical fallopian tube under hysterosalpingography(HSG).Methods A retrospective analysis was conducted based on the clinical data of 138 infertility patients with tortuous and vertical fallopian tube under HSG who underwent hysteroscopy combined with laparoscopy from March 2015 to March 2019.Results Hysteroscopy combined with laparoscopy found pelvic abnormality in 89.1%(123/138)of the patients,among which pelvic adhesion was the most common(87.0%,120/138).The rate of natural pregnancy after operation was 73.2%(101/138),intrauterine pregnancy was 68.1%(94/138),ectopic pregnancy was 5.1%(7/138),and live birth was 60.9%(84/138).The majority of pregnancies[85.1%(80/94)]occurred within 1 year after operation.Conclusions The infertility patients with tortuous and vertical fallopian tube under HSG are usually related to pelvic adhesion and other factors leading to infertility.The hysteroscopy combined with laparoscopy can achieve good therapeutic effect,and most patients get pregnancy within 1 year after operation.

关 键 词：子宫输卵管造影 不孕症 腹腔镜 宫腔镜 盆腔粘连 

分 类 号：R71[医药卫生—妇产科学]