宫腔镜联合腹腔镜在女性不孕症诊断及治疗中的应用

目的探讨宫腔镜联合腹腔镜在女性不孕症诊断及治疗中的应用价值。方法选择2007年1月至2010年12月北京市丰台中西医结合医院收治的200例不孕症患者,所有患者给予宫、腹腔镜联合检查明确病因并采取有针对性的治疗措施,治疗后随访3 a,观察治疗效果。结果 200例患者中,不孕症的病因主要有慢性盆腔炎、子宫内膜异位症、宫腔粘连和多囊卵巢综合征等。原发性不孕症与继发性不孕症的病因构成存在差异,子宫内膜异位症在原发性不孕症患者中的发生率高于继发性不孕症患者(P=0.001);慢性盆腔炎和宫腔粘连在继发性不孕症患者中的发生率高于原发性不孕症患者(P=0.047,P=0.039)。获得随访的196例患者中,正常妊娠96例,其中自然受孕69例,辅助妊娠27例,总妊娠率48.98%。结论宫腔镜联合腹腔镜检查能快速、准确地诊断不孕症的病因,并可及时采取针对性治疗措施,具有诊断准确、手术创伤小、术后妊娠率高等优势。

Application of hysteroscopy combined with laparoscopy in the diagnosis and treatment of female infertility

Objective To explore the value of hysteroscopy combined with laparoscopy in the diagnosis and treatment of female infertility. Methods A total of 200 patients with female infertility in Fengtai Hospital of Integrated Traditional and Western Medicine of Beijing City from January 2007 to December 2010 were selected. All patients were given hysteroscopy combined with laparoscopy and targeted treatment. The patients were followed up for three years to observe the therapeutic efficacy. Results The main causes of infertility in 200 patients were chronic pelvic inflammatory disease,endometriosis,intrauterine adhesions and polycystic ovary syndrome. The causes of primary infertility and secondary infertility were different. The rate of endometriosis in the patients with primary infertility was significantly higher than that in the patients with secondary infertility（P = 0. 001）. The rates of chronic pelvic inflammatory disease and intrauterine adhesions in the patients with secondary infertility were significantly higher than those in primary infertility（ P = 0. 047,P = 0. 039）. Among the 196 patients who were followed up,96 cases were normal pregnancy,the total pregnancy rate was 48. 98%. Among the 96 cases of normal pregnancy,69 cases were natural conception,27 cases were assisted pregnancy. Conclusion Hysteroscopy combined with laparoscope can quickly and accurately diagnose the cause of female infertility,and can promptly take targeted treatment. It has the advantages of exact diagnosis,minor surgical trauma and high postoperative pregnancy rate. Therefore,it is the reliable method for infertility diagnosis and treatment.