评估妇科内窥镜对输卵管阻塞性不孕治疗的价值

目的通过分析268例不同部位阻塞性不孕患者的疏通治疗结果,评估妇科内窥镜在治疗输卵管阻塞性不孕的价值。方法将268例输卵管阻塞性不孕患者分为4组,根据术前HSG影像或腹腔镜术中诊断将输卵管阻塞分为4型:近端阻塞型(A型),中远端阻塞型(B型),输卵管积水型(C型),输卵管和周围组织粘连、伞端闭锁型(D型)。4组通过妇科内窥镜实施输卵管疏通术并术后综合性抗炎治疗3个月,随诊1年,比较4组患者术后的正常妊娠、输卵管妊娠、再阻塞情况。结果4组疏通后1年内A组妊娠率最高,输卵管妊娠、再阻率最低;B、C组次之;C组妊娠率最低,输卵管妊娠、再阻率最高。结论炎症仅局限于输卵管的间质、峡部所致阻塞的患者,通过妇科内窥镜疏通术后,其妊娠率最高,输卵管妊娠发生率、再阻率低。

Evaluate Gynecological Endoscope Treatment Outcome in 268 Cases of Infertility Caused by Fallopian Tube Obstruction

Objective Through analysis of treatment outcome of 268 cases of infertility caused by fallopian tube obstruction in different portion,we can assess the value in the treatment of infertility caused by tubal obstruction through gynecologic endoscopic.Methods The 268 patients of infertility caused by tubal obstruction were divided into four groups and divided into four types of salpingemphraxis by hysterosalpingogram(HSG) or laparoscopic diagnosis,proximate obstruction(A type),middle and distal end obstruction(B type),hydrosalpinx(C type) and fallopian tube surrounded by adhesions or fimbria atresia(D type).The patients of 4 group were treated by deoppilation technique in fallopian tube through gynecological endoscope and comprehensiveness anti-inflammatory treatment for three months and Follow-Up for one year,to compare the difference in the patients of 4 group in normal pregnancy?fallopian pregnancy(TP) and the tubal reobstruction after the operation.Results In one year after deoppilation technique in fallopian tube,type A have the highest pregnancy rate and the lowest rates in the pregnancy(TP)? the tubal reobstruction.Conversely,D type have the lowest pregnancy rate and the highest rates in the pregnancy(TP),the B?C type is in the middle grade.Conclusion A type that obstruction caused by the inflammation only limited in the interstitial and isthmic portion of the tube,after the deoppilation by gynecological endoscope,have the highest pregnancy rate and the lowest rates in the pregnancy(TP)?the tubal reobstruction.