输卵管性不孕症手术治疗方式的比较及探讨

目的观察宫腔镜手术、腹腔镜手术和宫、腹腔镜联合术3种方式治疗输卵管性不孕症的临床疗效,并进行比较。方法 118例输卵管性不孕患者随机分为宫腔镜手术组（A组,n=38例）、腹腔镜手术组（B组,n=40例）及宫、腹腔镜联合手术治疗组（C组,n=40例）,记录各组手术时间、出血量、肛门排气时间、住院天数、术后输卵管通畅情况和术后宫内妊娠率等指标。结果 3组患者手术时间、出血量、肛门排气时间和住院天数比较差异无统计学意义（P〉0.05）;宫、腹腔镜联合手术组术后输卵管复通率和术后妊娠率均明显高于其他两组（P〈0.05）。结论宫、腹腔镜联合治疗输卵管性不孕具有输卵管复通率和术后妊娠率高等优点,值得临床推广应用。

A comparative study on surgical procedures in treatment of tubal infertility

Objective To observe and compare the clinical efficacy of hysteroscopic surgery, laparoscopic surgery and hysteroscopic combined with laparoscopic surgery in treatment of tubal infertility. Methods One hundred and eighteen patients with tubal infertility were randomly divided into hysteroscopic surgery group （group A, n = 38 ） , laparoscopic surgery group （group B, n = 40） and hysteroscopic combined with laparoscopic surgery group （ group C, n = 40 ）. The operating time, amount of blood lost, time for anal exhaust, duration of hospitalization, situation of postoperative tubal patency and rate of intrauterine pregnancy after surgery were recorded. Results The operating time, amount of blood loss, time for anal exhaust and duration of hospitalization between three groups showed no significant difference （ P 〉 0.05 ）. The tubal recanalization rate and pregnancy rate of patients in group C after surgery were significantly higher than those of other two groups （ P 〈 0.05 ）. Conclusion Hysteroscopic combined with laparoscopic surgery in treatment of tubal infertility has a higher rate of tubal reeanalization and pregnancy. It is worthy to be recommended for clinical application.