输卵管积水在不孕症治疗中的处理

目的：探讨输卵管重度积水的临床治疗选择。方法：回顾2005年5月至2010年12月输卵管伞部积水直径〉3cm施行了腹腔镜手术共850例,其中剔除合并子宫肌瘤、多囊卵巢综合征、子宫内膜异位症等干扰因素病例,仅输卵管积水、盆腔粘连患者553例。根据术中情况及患者要求,行输卵管复通、伞部成形手术的患者363例,行伞部成形、输卵管结扎190例。临床资料进行总结分析。结果：随访时间为3-24个月,平均13.5月,术后宫内妊娠率48%至38%。结论：输卵管分期III期以上的患者,其术后自然受孕率极低,复发率较高,可建议行体外受精或胚胎移植治疗。通过手术复通,并在术后加强维持其通畅及功能的治疗,有助于提高自然受孕率、体外受精或胚胎移植的成功。

The Management of Hydrosalpinx in Patients Suffered from Infertility

Objective： To explore the clinical treatment of hydrosalpinx.Method： 850 cases with 3cm in diameter of fimbria hydrosalpinx underwent operation under laparoscope.In all of them,553 cases with hydrosalpinx and pelvic adhesion except for the cases with hystermyoma,polycystic ovarian syndrome and endometrosis.The clinical data were analyzed of 363 cases of salpingostomy and fimbrioplasty,190 cases of fimbrioplasty and tubal ligation.Result： The pregnancy rate was 38% to 48% after following up for 3 to 24 months（average 13.5 months）.Conclusion： It suggests that the patients within stage III of oviduct should adopt invitro fertilization and embryo transplantation for the lower rate of pregnancy and the higher recurrence rate.The salpingostomy can improve the pregnancy rate and the succeed of invitro fertilization and embryo transplantation.