阴道注水腹腔镜与宫腔镜联合手术在盆腔病变致不孕症诊治中的作用研究  

Study on the Role of Combined Transvaginal Hydrolaparoscopic and Hysteroscopic Surgery in the Diagnosis and Treatment of Infertility Caused by Pelvic Lesions

作　　者：胡晓丽 张立敬 杜春园 王海波 韩慈 逯彩虹 甄银芝 武子先 赵霞 李苓妙 籍霞 HU Xiaoli;ZHANG Lijing;DU Chunyuan;WANG Haibo;HAN Ci;LU Caihong;ZHEN Yinzhi;WU Zixian;ZHAO Xia;LI Lingmiao;JI Xia(Department of Obstetrics,the Affiliated Hospital of the Military Medical University of the Chinese People's Liberation Army,Shijiazhuang 050000,China;Department of Gynecology,the Affiliated Hospital of the Military Medical University of the Chinese People's Liberation Army,Shijiazhuang 050000,China;Department of Medical Imaging,the Affiliated Hospital of the Military Medical University of the Chinese People's Liberation Army,Shijiazhuang 050000,China)

机构地区：[1]中国人民解放军陆军军医大学士官学校附属医院产科,石家庄050000 [2]中国人民解放军陆军军医大学士官学校附属医院妇科,石家庄050000 [3]中国人民解放军陆军军医大学士官学校附属医院医学影像学科,石家庄050000

出　　处：《临床误诊误治》2024年第8期58-62,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会项目(20211370)。

摘　　要：目的探讨阴道注水腹腔镜与宫腔镜联合手术在盆腔病变所致不孕症治疗中的作用。方法选取2020年1月—2022年12月86例盆腔病变所致不孕症为研究对象,随机数字表法分为对照组43例和研究组43例,对照组给予常规输卵管通液手术治疗,研究组给予阴道注水腹腔镜与宫腔镜联合手术治疗。比较2组妊娠与复发情况、并发症发生情况、输卵管再通率以及治疗前后健康状况调查简表(SF-36)评分。结果研究组临床宫内孕发生率以及输卵管再通率较对照组更高,且异位妊娠率、未自然受孕率、复发率以及并发症总发生率较对照组更低(P<0.05)。治疗后,2组物质功能、社会功能、日常生活、心理功能维度SF-36评分较治疗前明显升高,且研究组不同维度SF-36评分较对照组更高(P<0.05)。结论对盆腔病变所致不孕症患者施以阴道注水腹腔镜与宫腔镜联合手术治疗的效果明显,能够有效提高输卵管再通率,降低并发症以及复发率,并帮助患者尽快受孕,从而改善整体的生活质量。Objective To investigate the effect of combined transvaginal hydrolaparoscopic and hysteroscopic surgery in the treatment of infertility caused by pelvic lesions.Methods A total of 86 patients with infertility caused by pelvic lesions from January 2020 to December 2022 were selected as the research subjects,and were divided into control group(n=43)and research group(n=43)according to random number table method.The control group received conventional hydrotubation,and the research group received combined transvaginal hydrolaparoscopic and hysteroscopic surgery.Pregnancy and recurrence,complications,fallopian tube recanalization rate and the MOS item short from health survey(SF-36)score before and after treatment were compared between the two groups.Results The clinical incidence of intrauterine pregnancy and fallopian tube recanalization in the research group were higher than those in the control group,and the ectopic pregnancy rate,unspontaneous pregnancy rate,recurrence rate and total complication rate were lower than those in the control group(P<0.05).After treatment,SF-36 scores of material function,social function,daily life and psychological function in the two groups were significantly higher than those before treatment,and SF-36 scores of different dimensions in the research group were higher than those in the control group(P<0.05).Conclusion The combined transvaginal hydrolaparoscopic and hysteroscopic surgery has obvious effects on infertility patients caused by pelvic lesions,which can effectively improve the overall fallopian tube recanalization rate,reduce complications and recurrence rate,and help patients get pregnant as soon as possible,so as to improve the overall quality of life.

关 键 词：不孕症 阴道注水 腹腔镜 宫腔镜 妊娠 输卵管再通 并发症 生活质量 

分 类 号：R711.6[医药卫生—妇产科学]