宫腹腔镜联合导丝治疗复杂性输卵管阻塞

目的:探讨宫腹腔镜联合导丝在治疗复杂性输卵管阻塞的临床价值。方法:采用宫腔镜、腹腔镜和介入导丝三者联合的方法治疗输卵管阻塞164例患者共319条输卵管。结果:319条输卵管中有202条输卵管存在程度不同的粘连,其中,伞端包埋32条,伞端闭锁积水136条,45例患者双侧输卵管积水;经腹腔镜盆腔粘连松解术及输卵管伞端造口成形术等相关手术后,88条输卵管经单纯输卵管导管加压注药即疏通成功,215条输卵管单纯导管加压注药疏通无效,改用导管内导丝疏通后成功,319条输卵管中有303条输卵管疏通成功,疏通成功率94.98%(303/319),16条输卵管疏通无效。结论:宫膜腔镜联合介入导丝治疗输卵管阻塞可以弥补各自单独治疗的不足,疏通成功率高,可作为辅助生育技术的筛查诊断和治疗,有很好的经济效益和良好的社会效益。

Gulided wire treatment of complicated occlusion of oviduct under hysteroscope combined with laparoscope

Objective:To investigate the clinical value of guided wire treatment of complicated occlusion of oviduct under hysteroscope combined with laparoscope.Methods:Treated oviduct occlusion of 319 tubes of 164 cases with guided wire under hysteroscope combined with laparoscope.Results:There were different degree adhesion in 202 tubes of the total 319 tubes.Among them,32 fimbriate portions were covered up,136 fimbriate portions were distally occluded and blinded,45 were distally occluded and blinded bilateral.After lysis of pelvic adhesions under abdominoscope and stomatoplasty of fimbriated extremity of fallopian and other related operations,88 tubes were cleared out while recanalization with simply pressurized conduct,215 cases were not successful,while changing with conduct with wire inside,recanalization were successful.303 of 319 tubes were recanalized successfully.Success rate was 94.98%(303/319),16 cases were not successful.Conclusion:Gynecologic endoscope and intervened wire made up with each other when treating occlusion of oviduct.Success rate of recanalization is high.They can be methods for sieving,diagnosing and treating of assisted reproductive techniques.There is good economic efficiency and social benefit.