宫腔镜、腹腔镜联合手术治疗输卵管积水286例分析

目的:探讨宫腔镜、腹腔镜联合手术治疗输卵管积水的安全性和疗效。方法:在腹腔镜下行输卵管伞端造口术、成形术后,在宫腔镜下行输卵管插管通液术。结果:286例患者均顺利完成两镜联合手术,无不良并发症发生,手术成功率82.52%,手术时间50~130m in,平均90m in,出血量20~120m in,平均70m l。153例随访一年,随访率53.5%,术后妊娠73例,占随访病例的47.7%,其中宫内妊娠流产18例,输卵管妊娠6例;其余80例术后随访1年仍未孕经HSG检查发现输卵管积水6例,占7.5%。结论:宫腹腔镜联合手术治疗输卵管积水患者创伤小、效果好、康复快,可替代开腹手术。

Laparoscopy combined with hysteroscopy in the treatment of hydrosalpinx: with a report of 286 cases

Objective:To evaluate the value and safety of laparoscopy combined with hysteroscopy in the treatment of hydrosalpinx.Methods:After performing neosalpingostomy by laparoscopy the hydrotubation was performed by hysteroscopy.Results:286 cases had been operated successfully,no complications occured,6 cases of salpingectomy had been performed,12 cases of abdominal tuberculosis were diagnosed.The successful rate of laparoscopic surgery was 82.52%,the mean operative time was 90 minutes,mean blood loss was 70ml.153 cases of neosalpingostomy were followed up,the follow up rate was 57.08%,and the mean follow up time was 12 months,73 patients were intrauterine pregnancy,18 cases were abortion,and 6 patiens were ectopic pregnancy.80 patients were not pregnant of which 6 cases were hydrosalpinx 1 year after operation.Conclusions:Laparoscopy combined with hysteroscopy can not only diagnose the cause of infertility but also cure some patients,It has advantages of simplicity,minimal invasion and rapid recovery.