宫腹腔镜联合应用诊治输卵管性不孕的临床研究

目的:探讨宫腔镜、腹腔镜联合诊治输卵管阻塞性不孕的效果。方法:对诊断为不孕症的病人,首先进行输卵管通液术,对于通液结果为输卵管不通者,应用76%的泛影葡胺行子宫、输卵管造影。对诊断为双侧输卵管阻塞者则宫腔镜与腹腔镜联合应用,宫腔镜下观察宫腔内、输卵管、子宫口是否存在病变,做选择性输卵管插管通液术,腹腔镜直视下观察输卵管阻塞度及阻塞部位,并做相应手术。结果:双侧通畅15例,一侧通对侧阻塞9例,一侧通而不畅对侧通畅6例,双侧阻塞2例。均较单用宫腔插管通液效果好。结论:宫、腹腔镜联合能充分利用二者的优点,相互补充,明确输卵管阻塞的部位和程度,对输卵管复通有一定临床价值。

Clinical study of laparoscope combined with hysteroscope in the diagnosis and treatment of tubal infertility

Objective:To study the effects of hysteroscope combined with laparoscope in the diagnosis and treatment of tubal obstructive infertility.Methods:First of all,the hydrotubation was performed in the patients with infertility confirmed on clinic,and then the hystero-salpingography(HSG) with compound meglucamine diatrizoate was utilized for these patients with tubal occlusion after hydrotubation.Hysteroscope combined with laparoscope was used to observe whether or not there was pathologic change in the uterine cavity and the uterotubal junction in these patients diagnosed as bilateral tubal obstruction and perform the selective hydrotubation.Under direct vision of laparoscope,the degree and site of tubal obstruction were detected respectively,and the relevant operation was done.Results:The results showed that bilateral uterine tubes were unobstructed in 15 cases,unilateral uterine tube was unobstructed and contralateral uterine tube obstruction in 9 cases,unilateral uterine tube semi-unobstructed and contralateral unobstructed in 6 cases and bilateral tubal obstruction in 2 cases.The unobstructed rate of hysteroscope combined with laparoscope was better than that only with hysteroscope.Conclusion:Hysteroscope combined with laparoscope can fully utilize the advantages of them,with reciprocal supplement,and define the sites and degrees of occlusion.It is of some clinical value for the tubal recanalization.