宫腹腔镜联合手术诊治输卵管因素不孕不育症疗效探讨.docVIP

宫腹腔镜联合手术诊治输卵管因素不孕不育症疗效探讨 　　[摘要] 目的 探讨使用宫腹腔镜联合手术诊治输卵管因素不孕不育症的疗效。 方法 整群选取2011年7月―2014年6月间南通和美家妇产科医院妇产科收治的254例输卵管因素导致的不孕不育症患者作为研究对象，使用宫腹腔镜进行诊断和治疗，观察堵塞的输卵管再通率和1年内妊娠率。 结果 输卵管因素导致不孕不育的原因为粘连扭曲、伞端闭锁、输卵管积液阻塞等，予以宫腹腔镜联合行粘连分解、输卵管造口、输卵管导丝通管等手术治疗。手术后输卵管复通率为89.8%，1年内妊娠率为38.2%；将手术前后输卵管通畅率进行比较，差异有统计学意义（P0.05）。 结论 使用宫腹腔镜联合手术诊治输卵管因素不孕不育症，具有创伤轻、痛苦小，术中确诊率、术后输卵管复通率和妊娠率高。 　　[Abstract] Objective To discuss and observe the curative effect of the application of laparoscopy combined with operation in diagnosis and treatment of infertility caused by tubal factors. Methods 254 cases of patients with infertility caused by tubal factors treated in the obstetrics and gynecology department of Nantong Hemeijia Obstetrics and Gynecology Hospital from July 2011 to June 2014 were selected as the research object and diagnosed and treated with laparoscopy， the recanalization rate of occluded salpinx and pregnancy rate in 1 year were observed. Results The tubal factors leading to infertility were adhesion distortion， distal occlusion， sactosalpinx occlusion and treated respectively with adhesion decomposition， salpingostomy and salpinx godet siphunculus， all operative treatments were combined with laparoscopy， after operation， the recanalization rate of salpinx was 89.8%，the pregnancy rate in 1 year was 38.2%， the difference in the recanalization rate of salpinx before and after operation was obvious （P0.05）. Conclusion The application of laparoscopy combined with operation in diagnosis and treatment of infertility caused by tubal factors has less trauma and less pain， and the intraoperative diagnostic rate， postoperative recanalization rate of salpinx and the pregnancy rate are high. 　　[Key words] Infertility； Tuba factors； Laparoscopy； Pregnancy rate； Curative effect 　　不孕不育症是指夫妻双方在正常性生活情况下，未采取避孕措施满一年尚未妊娠者；最主要病因为输卵管积液、堵塞、扭曲变形等输卵管因素最为常见，约占50%[1]。随着人们社会价值观的改变，生活和工作节奏的加快，生殖道感染和人流次数的增加，不孕不育症的发病率逐年上升，给夫妻生活、家庭和社会均带来显著的负面影响[2]。不孕不育症病因很复杂，至今仍有许多原因尚未查明。随着医疗仪器设备和妇科医疗技术的快速发展，宫腔镜和腹腔镜已经广泛应用于不孕不育症的临床诊断治疗中。现对2011年