宫腔镜联合腹腔镜在女性不孕症中的应用价值研究

目的：探讨宫腔镜与腹腔镜联合在诊治女性不孕症中的临床应用价值。方法回顾性分析2011年1月-2012年7月因不孕症在秦皇岛市妇幼保健院行腹腔镜联合宫腔镜诊治的146例患者的临床资料。结果59例为原发性不孕，占40．4％；87例为继发性不孕，占59．6％。不孕时间为1～17年，平均不孕时间为（3．2±2．6）年。术前估计116例患者宫腔正常，其中26例经宫腔镜诊断为宫腔异常，宫腔异常率占22．41％；术前估计30例患者宫腔异常，其中21例经宫腔镜诊断为宫腔异常，宫腔异常率占70．0％。2组患者宫腔异常率的差异有统计学意义（P＜0．05）。以宫腔镜检查为标准诊断宫腔内病变，超声检查阳性预测值为70．8％，阴性预测值为75．4％；子宫输卵管摄影检查（HSG）诊断宫腔内病变的阳性预测值为71．4％，阴性预测值为76．0％。结论宫腔镜与腹腔镜手术联合，可提高宫腔异常的检出率，并有效治疗不孕症。

Application of combined hysteroscopic and laparoscopic findings in female infertility

Objective To evaluate the application of combined hysteroscopic and laparoscopic findings in female in -fertility.Methods Clinical data were collected from 146 female patients who were admitted to our hospital from January 2011 to July 2012 due to infertility and received combined laparoscopic and hysteroscopic examinations .The data were retrospectively analyzed to determine the cause of infertility and postoperative pregnancy rate .Results 59 patients （40.4%） were diagnosed with primary infertility , in contrast with 87 patients （59.6%） with secondary infertility.The duration of infertility ranged from 1 to 17 years, with an average of （3.2 ±2.6） years.Before examination, 116 patients were estimated to have normal uterine cavity , which was then reversed in 26 cases using hysteroscopy （22.41%）.Before examination, 30 patients were estimated to present anomalies in the uterine cavity , which was determined in 24 cases by hysteroscopy （70.0%）.The abnormal rates of the uterine cavity between the two groups were statistically different （P〈0.05）.If hysteroscopic findings were set as the standard for the diagnosis of intrauterine lesions , the positive predictive value was 70.8%for ultrasound examination, and 71.4%for hysterosalpingogram （HSG）, while the negative predictive value was 75.4%for ultrasound scan and 76.0%for HSG.Conclusion Combined hysteroscopic and laparoscopic ex-aminations can facilitate infertility detection and improve relevant treatment .