应用防粘连隔离膜在腹腔镜下盆腔粘连松解治疗不孕症的临床意义_医学论文.docVIP

应用防粘连隔离膜在腹腔镜下盆腔粘连松解治疗不孕症的临床意义_医学论文 应用防粘连隔离膜在腹腔镜下盆腔粘连松解治疗不孕症的临床意义_医学论文 作者:李文成 舒爱娥 王优快 　　【摘要】 目的 探讨腹腔镜下盆腔粘连松解术中应用防粘连隔离膜治疗不孕症的安全性和有效性。方法 自2006年2月至2008年12月,对226例不孕患者在本院用腹腔镜行盆腔粘连松解,随机分为2组,治疗组112例术中应用防粘连剂。记录盆腔粘连与松解情况、输卵管通畅性及术后妊娠情况。结果 ①腹腔镜下盆腔粘连松解,输卵管染色通液中发现42条近端梗阻,治疗组疏通199条输卵管,对照组疏通211条输卵管②术后无并发症发生,72~96 h出院③随访情况:术后随访13~23个月。治疗组输卵管再闭塞率2.01%(4/199)低于对照组,两组比较治疗组差别有显著意义。治疗组受孕率59.82%(67/112),对照组2例失访,受孕率41.07%(46/112),两个治疗组比较其差别有显著意义(0.01)。结论 腹腔镜下盆腔粘连松解术中应用防粘连剂治疗不孕症可行、有效,术后再闭塞率低,受孕率高。 　　【关键词】不孕女性盆腔粘连松解预防粘连 　　【Abstract】 Objective To investigate the safety and efficacy of hydrolaparoscopic pelvic adhesiolysis applied membrane for anti-adhesion in the infertile women.Methods From February 2006 to December 2008,226 infertile patients underwent hydrolaparoscopic pelvic adhesiolysis applied membrane for anti-adhesion.They have been divided into two groups,The study group apply membrane for anti-adhesion after operation.The diuation of the operation and discharge,pelvic adhesions scored,oviducts patency,complications and pregrancy rate were investigated.Results ①Hydrolaparoscopic pelvic adhesiolysis.42 oviducts were of proximal occlusion by dye-test.There were 199 oviducts unobstructedin the study group and 211 oviducts unobstructedin the control group.②The duration of be hospitalized 72-96 hours,no complications occurred.③the condition of follow-up:in the 13-23 months’ follow-up,The rate of oviduct block again after operation was 2.01%(4/199)in the study group is lower than in the control group(0.01).The rate of pregnancy was 59.82%(67/112)in the study group is higher than the control group(0.01).Conclusion Hydrolaparoscopic pelvic adhesiolysis apply membrane for anti-adhesion is safe,efficacious,the rate of oviduts block again after operation is lower with higher pregrancy. 　　【Key words】 　　Infertility Female Pelvic adhesiolysis Anti-adhehesion 　　 　　女性因素不孕占40%,其中15%~20%女性不孕由盆腔粘连所致[1],经腹腔镜下能有效松解盆腔粘连,但是术后易复发,为探索一种更有效的方法, 南华大学附属怀化医院自2006年2月至2008年12月对226例存在不同程度盆腔粘连的不孕症患者实施了腹腔镜下盆腔粘