输卵管性不孕患者腹腔镜下病因及病变分析

目的：了解输卵管性不孕的病因及与输卵管和盆腔病变的关系，方法：对50例输卵管性不孕的患者，腹腔镜手术中检查输卵管及盆腔病变情况，取输卵管远端组织病理检查及淋球菌，沙眼衣原体，支原体DNA－PCR检测，调查患者的不孕年限及宫腔操作次数，及其与病理变化的关系。结果：输卵管结核，淋病，衣原体感染，支原体感染，子宫内膜异位症的构成比分别为6％，16％，18％，16％，22％，输卵管和淋病与输卵管及盆腔病变严重程度呈正相关，子宫内膜异位症与输卵管粘膜损害呈负相关，不孕年限与病变严重程度关系不显著，术前宫腔操作次数和双侧输卵管受损呈明显正相关，结论：输卵管性不肝患 输卵管病变由多种感染性疾病引起，宫腔操作可能是其高危因素，其中结核和淋病造成的输卵管盆腔病变最严重。

To Investigate the Etiology and Pathological Change of the Tubal Infertility with Laparoscope

Objective:To study the etiology of tubal infertility and the relationship between the etiology and the pathologic change of the fallopian tube and pelvic. Methods:Fifty laparoscope patients with tubal infertility, using a piece of tubal lacinire, the pathologic diagnose was done; the DNA of Neisseria gonorrhea(NG), Chlamydia Trachomatis (CT),mycoplasma was examined with polymerase chain reaction (PCR).The duration of infertility and times of intrauterine operation in the history was investigated. Results:The proportion of tubal tuberculosis(TB), gonorrhea, CT infection, mycoplasma infection and endometriosis respectively was 6%, 16%, 18%, 16% and 22%. The pathologic change in fallopian tube and pelvic was positive correlative with tubal TB and gonorrhea (P<0.05), and it is not significantly with the duration of infertility.The damage of tubal mucosa was not negative correlative with endometriosis.The duration of intrauterine operation was positive correlative with bilateral tubal damage.Conclusions:The tubal pathologic change in tubal infertility was caused by various infective diseases, and the degree of tubal pathological change is most serious by TB or gonorrhea. The intrauterine operation may be the risk of tubal infertility.