腹腔镜下盆腔粘连松解术与输卵管伞端造口术联合应用于盆腔炎性不孕症患者中的效果分析  

Analysis of the Effect of Laparoscopic Pelvic Adhesiolysis Combined with Salpingostomy in the Treatment of Pelvic Inflammatory Infertility

作　　者：王荣龙 许晓贞 施飞凤 汤雅贞 WANG Ronglong;XU Xiaozhen;SHI Feifeng;TANG Yazhen(Department of Gynecology,Zhangzhou Hospital,Fujian Medical University,Zhangzhou 363000,China)

机构地区：[1]福建医科大学附属漳州市医院妇科,福建漳州363000

出　　处：《中国医药指南》2023年第10期99-101,122,共4页Guide of China Medicine

摘　　要：目的探讨盆腔炎性不孕症患者采用腹腔镜下盆腔粘连松解术与输卵管伞端造口术联合治疗的效果。方法选取2020年1月至2021年12月本院收治的103例盆腔炎性不孕症患者作为研究对象,按照随机数字表法进行分组,即对照组(51例)与研究组(52例)。对照组采取宫腔镜下输卵管插管通液术治疗,研究组采用腹腔镜下盆腔粘连松解术与输卵管伞端造口术联合治疗。观察并比较两组患者术中与术后情况、性激素水平[黄体生成素(LH)、促卵泡激素(FSH)、催乳素(PRL)、雌二醇(E_(2))]、术后并发症情况以及随访1年的生育结局。结果研究组手术时间与住院时间长于对照组(P<0.05),两组术后腹痛消失时间对比,结果未见差异性(P>0.05)。两组术前E_(2)、PRL、FSH、LH水平比较,结果未见差异性(P>0.05);研究组术后3个月时E_(2)水平高于对照组,FSH水平低于对照组(P<0.05),两组PRL、LH水平比较,结果未见差异性(P>0.05)。两组术后并发症情况的发生率对比,结果未见差异性(P>0.05)。随访1年发现,研究组异常位妊娠率低于对照组,自然受孕率高于对照组(P<0.05)。结论盆腔炎性不孕症患者采用腹腔镜下盆腔粘连松解术与输卵管伞端造口术联合治疗,可以有效提高自然受孕率,改善性激素水平,安全性佳。Objective To explore the effect of laparoscopic pelvic adhesiolysis combined with salpingostomy in the treatment of pelvic inflammatory infertility.Methods One hundred and three patients with pelvic inflammatory infertility admitted to our hospital from January 2020 to December 2021 were selected as the study subjects and divided into control group(51 cases)and study group(52 cases)according to the random number table.The control group was treated with hysteroscopic tubal intubation and fluid drainage,while the study group was treated with laparoscopic tubal fimbria ostomy and pelvic adhesion lysis.The intraoperative and postoperative conditions,hormone levels[luteinizing hormone(LH),follicle-stimulating hormone(FSH),prolactin(PRL),estradiol(E_(2)),]postoperative complications,and fertility outcomes of the two groups were observed and compared.Results The operation time and hospitalization time of the study group were longer than that of the control group(P<0.05),there was no difference between the two groups in the disappearance time of abdominal pain after operation(P>0.05).There was no difference in the levels of E_(2),PRL,FSH and LH between the two groups before operation(P>0.05).The E_(2) level in the study group was higher than that in the control group,and the FSH level was lower than that in the control group at 3 months after operation(P<0.05).There was no difference between the PRL and LH levels in the two groups(P>0.05).There was no difference in the incidence of postoperative complications between the two groups(P>0.05).One year follow-up found that the abnormal pregnancy rate in the study group was lower than that in the control group,and the natural pregnancy rate was higher than that in the control group(P<0.05).Conclusion The combination of laparoscopic pelvic adhesiolysis and salpingostomy can effectively improve the natural pregnancy rate of patients with pelvic inflammatory infertility,improve the level of sex hormones,with good safety.

关 键 词：腹腔镜 盆腔粘连松解术 输卵管伞端造口术 盆腔炎性不孕症 

分 类 号：R71[医药卫生—妇产科学]