宫、腹腔镜联合人工授精技术治疗输卵管性不孕的探讨

目的:评价宫腹腔镜联合人工授精技术治疗输卵管性不孕的效果.方法:对住我院的200例因输卵管原因引起的不孕症患者采用宫、腹腔镜联合手术进行检查并视术中的不同情况进行不同的手术方式治疗.结果:术后3个月内有21例妊娠；术中、术后常规给予促排卵治疗,监测排卵,指导性生活时间；术后3个月未受孕给予人工授精组68例,妊娠43例,妊娠率为63.2％,未人工授精组85例,妊娠34例,妊娠率为40.0％,两组妊娠率有显著性差异(P＜0.05)；随访追踪,共有98例妊娠,妊娠率为49％.而异位妊娠3例,占1.5％.结论；宫腔镜可直视下诊治宫腔疾患和输卵管近端的病变,腹腔镜则可诊治盆腔疾患和输卵管远端的病变.联合应用能同时治疗宫腔、盆腔及输卵管异常,对输卵管通畅性作出准确评价,术后辅以促排卵、人工授精技术,可为输卵管性不孕患者提供更多的妊娠机会.

Hysteroscope and laparoscope combined with artificial insemination technique in the treatment of tubal infertility

Objective:To evaluate the effect of hysteroscope and laparoscope combined with artificial insemination technique in treating tubal infertility.Methods:200 tubal infertility patients in our hospital from were treated by different surgical methods according to the different circumstances in the surgeries of laparoscope combined with hysteroscope.Results:1.Three months after the surgery,there were 21 cases of pregnancy;2.Ovulation,ovulation monitoring and guiding of time of sex life were given to patients during and post-operation.3.Three months after operation,68 non-pregnant patients were given artificial insemination,and 43 cases became pregnant with the pregnancy rate of 63.2%;while among the 85 non-artificial insemination patients,there were 34 cases of pregnancy with the pregnancy rate of 40.0%.There was no significant difference between the two groups in pregnancy rate(P<0.05);4.Follow-up track found that there were a total of 98 cases of pregnancy with the pregnancy rate of 49%.And there were three cases with ectopic pregnancy,accounting for about 1.5%.Conclusion:Hysteroscopy may be used to diagnosis and treat the lesions of intrauterine and the proximal fallopian under direct visions.And laparoscopic may be applied to the diagnosis and treatment of pelvic disorders and distal tubal lesions.The combination of the two techniques can be used to treat intrauterine lesions,pelvic disorders and the tubal abnormalities.And also,they can make an accurate evaluation of the patency of the fallopian tubes.Supplemented with ovulation-inducing,artificial insemination technique,tubal infertility patients may get more opportunities for pregnancy.