腹腔镜检查不孕症398例分析

目的 应用腹腔镜诊断技术探讨不孕症的病因，评价腹腔镜对不孕症的诊断价值。方法 应用腹腔镜对398例不孕症妇女的盆腔疾病和不孕的影响因素进行分析。结果 腹腔镜检查发现盆腔器质性病变359例，检查阳性率为90．20％。慢性盆腔炎、子宫内膜异住症和多囊卵巢是引起不孕的主要盆腔疾病，分别占54．52％、18、34％和10，30％；慢性盆腔炎患者中91．70％有1侧或双侧输卵管梗阻；子宫内膜异住症患者中20．55％有输卵管梗阻。本资料398例中，有156例病人术前进行了输卵管碘油检查，96例与腹腔镜检查结果一致，两者符合率为61．53％；术前227例患者进行阴道超声检查，经腹腔镜证实159例，符合率70．04％(159／227)。结论 应用腹腔镜技术对不孕症的病因诊断有重要价值，盆腔炎输卵管梗阻率在继发不孕患者中的发病率高于原发不孕患者；在原发不孕惠者中，以子宫内膜异位症、多囊卵巢多见；对怀疑有盆腔疾病或原因不明的不孕患者应尽早腹腔镜诊治。

Analysis of 398 female patients with infertility under laparoscopy

To investigate the cause of infertility and evaluate the diagnostic value of laparoscopy in disgnosis of infertility. The relationship between pelvic disease and infertility in 398 female patients with laparoscopy was analyzed. 359 of 398 cases with infertility (90.20%) had pelvic diseases. Pelvic inflammatory disease? endometriosis and polycystic ovarian syndrome(PCOS) were major causes resulting in infertility, approximately 54.52%, 18.34% and 10.30% respectively. There were 91.70% patients with pelvic inflammatory disease and 20.55% with endometriosis presented fallopian obstruction. Among 398 cases, hysterosalpingraphy (HSG) was studied in 156 patients before laparoscopy, the results of 96 cases were coincident with laparoscopy, accounting 61.53%. 227 cases received vaginal ultrasonographic examination, the results of 159 cases(70.04%) were confirmed by laparoscopy. Conclusion] The important value of laparoscopy in diagnosis infertility has been known, the morbidities of pelvic inflammatory disease and endometriosis are higher in secondary infertility than that in primary infertility. Endometriosis and PCOS are most often seen in primary infertility. The patients which are suspected with pelvic disease or with unknown infertility should be operated by laparoscopy as soon as possible.