宫腹腔镜联合镜检不孕症患者377例临床分析

目的探讨引起不孕的主要因素及宫腹腔镜联合镜检在诊治不孕症中的价值.方法对诊断为不孕症的377例患者行宫腹腔镜联合镜检及相应手术治疗,进行回顾性分析.结果原发性不孕患者190例,主要病因是盆腔黏连93例(48.95%),宫内膜息肉47例(24.74%),输卵管阻塞伴或不伴输卵管积水46例(24.21%);继发性不孕患者187例,主要病因是盆腔黏连154例(82.35%),输卵管阻塞伴或不伴输卵管积水85例(45.45%),多囊卵巢综合征19例(10.16%).宫腹腔镜联合镜检与单纯宫、腹腔镜诊疗不孕症相比,诊断率明显提高(P＜0.05).结论宫腹腔镜联合镜检,女性不孕的主要原因为盆腔黏连、宫内膜息肉和输卵管阻塞伴或不伴输卵管积水和多囊卵巢综合征;宫腹腔镜联合镜检实现了两种微创手术的优势互补,漏检率低,诊疗同步.

An Analysis of 377 Infertile Patients Examined by Combined Laparoscopy and Hysteroscopy

Objective To investigate the diagnostic value of laparoscopy combined with hysteroscopy in patients with infertility. Methods From Jan 2002 to Sep 2004, a retrospective analysis of 377 infertile women who had accepted examination and correlative treatment under the combined laparoscopy and hysteroscopy. Results The leading cause of primary infertility was chronic pelvic inflammatory disease (93 cases, 48.95%), the second one was endometrial polyps (47 cases, 24.74%) and the third one was fallopian tube obstruction(46 cases, 24.21%). The causes of secondary infertility were chronic pelvic inflammatory disease(154 cases, 82.35%), fallopian tube obstruction ( 85 cases, 45.45% ) and polycystic ovarian (19 cases, 10.16%). Compared with laparoscopy alone or hysteroscopy alone, laparoscopy combined with hysteroscopy was superior in the diagnosis(P<0.05). Conclusions The more important cause of female infertility patients are chronic pelvic inflammatory disease, fallopian tube obstruction, endometrial polyp and polycystic ovarian. Laparoscopy combined with hysteroscopy can not only diagnose the causes of infertility comprehensively but also treat directly.