腹腔镜联合纤维宫腔镜行输卵管插管在输卵管性不孕症中应用.doc

腹腔镜联合纤维宫腔镜行输卵管插管在输卵管性不孕症中应用[摘要] 目的:探讨腹腔镜联合纤维宫腔镜行输卵管插管疏通术在诊断治疗输卵管性不孕症中的临床价值。方法:选择经子宫输卵管碘油造影诊断为输卵管性不孕的患者95例,住院行腹腔镜联合纤维宫腔镜行输卵管插管疏通术,并视术中所见选择不同的手术方式进行相应的治疗。结果:95例患者,共188条输卵管,其中输卵管不通150条,经插管疏通术后,成功率为88.0%。结论:腹腔镜联合纤维宫腔镜行输卵管插管疏通术治疗输卵管性不孕症,效果理想,值得临床推广应用。 [关键词] 腹腔镜检查;纤维宫腔镜检查;输卵管插管;输卵管性不孕症 [中图分类号] R711.6[文献标识码]A [文章编号]1674-4721(2010)04(b)-034-02 Clinical usage on treatment of oviductive infertility with intubation were performed by means of laparoscopy combined with fiber-hysteroscopy WANG Juan, HE Caijun, WANG Jun, HUANG Caihong, ZHENG Dongmei (Prenatal and Postnatal Care Center, the 211st Hospital of PLA, Harbin 150080, China) [Abstract] Objective: To explore the clinical value on treatment of oviductive infertility with intubation and recanalization performed by means of laparoscopy combined with fiber-hysteroscopy. Methods: 95 cases of patients with oviductive infertility were diagnosed by hystero-salpingography. They were treated by intubation and recanalization performed by means of laparoscopy combined with fiber-hysteroscopy. Results: There were 188 oviducts among 95 cases, 150 cases were obstructive oviducts. The successful rate of operation was 88.0%. Conclusion: The therapy to tubal infertility by intubation and recanalization performed by means of laparoscopy combined with fiber-hysteroscopy is effect and ideal, it′s worth of clinical use. [Key words] Laparoscopy; Fiber-hysteroscopy; Oviduct intubation; Oviductive infertility 不孕症是影响男女双方身心健康的疾病。在女性因素所致的不孕症中,输卵管因素约占1/2[1]。既往常规行输卵管通液和子宫输卵管碘油造影来判断输卵管是否通畅,但准确率不高,且达不到有效治疗的目的。随着妇科微创观念的普及、内镜技术的快速开展,宫腹腔镜技术在妇科不孕症诊治中的应用日益普及,使不孕症的诊治效果明显提高[2-4]。现将我院近年来宫腹腔镜诊治不孕症的临床结果总结如下: 1 资料与方法 1.1 一般资料 2006年12月～2009年4月,我院优生优育门诊不孕症诊室收治不孕症患者95例,全部经子宫输卵管碘油造影术证实为输卵管阻塞性不孕,其中,年龄21～39岁,平均29.6岁;原发性不孕37例,继发性不孕58例。95例患者共188条输卵管,其中2例因异位妊娠切除单侧输卵管。术前常规检查均正常,无手术禁忌证。男方精液检查未见异常。 1.2 方法 1.2.1 术前准备①手术时间:选择月经干净后2～5 d进行手术。②手术器械:采用日本Olympus电视腹腔镜及宫腔镜设备;CO2气腹机;膨宫介质为甘露醇。③麻醉方法:采用全身麻醉气管插管。 1.2.2 手术方法包括3个方面:①腹腔镜手术:常规脐孔及左右下腹穿刺,