宫腹腔镜联合RF导丝治疗输卵管阻塞性不孕症98例分析

目的:探讨宫腹腔镜联合RF导丝在输卵管阻塞性不孕中的应用价值。方法:回顾性分析2014年1月—2016年2月本院收治的98例输卵管阻塞性不孕患者,分析宫腹腔镜联合检查术中输卵管阻塞的原因、评价子宫输卵管造影及宫腔镜下输卵管插管通液术两种输卵管检查方法的准确率,统计宫腹腔镜联合RF导丝治疗输卵管阻塞的治疗效果、不良反应及术后妊娠结局。结果:本研究共纳入患者98例,输卵管192条。输卵管阻塞原因以输卵管管腔粘连及周围粘连为主;术前子宫输卵管造影检查的准确度为54.5%,宫腔镜下输卵管插管通液术的准确度为85.7%。术中诊断89例输卵管阻塞患者中64例行双侧或单侧RF导丝扩通术,共扩通输卵管94条,术后总通畅率79.8%,术后随访率80.6%,活产率为45.6%。结论:宫腹腔镜联合RF导丝治疗输卵管阻塞性不孕,可针对病因治疗,术后输卵管通畅率及妊娠率较高,值得临床推广。

Application of Hystero-laparoscopic Surgery Combined with RF Catheter in 98 Patients with Tubal Infertility

Objective:To evaluate the therapeutic efficiency of the hystero-laparoscopy combined with RF catheter in those patients with tubal obstructive infertility.Methods:A retrospective analysis was performed in 98 cases with tubal obstructive infertility,from January 2014 to February 2016,who treated with hystero-laparoscopy combined with RF catheter.The reason of tubal obstruction was analyzed.The accuracy of the uterus oviduct imaging and hysteroscopic tubal intubation was compared.The therapeutic efficiency,adverse reaction and the postoperative outcome of pregnancy were analyzed.Results:The reasons of tubal obstruction mainly included the lumen adhesion and peritubal adhesion.The accuracy in the uterus oviduct imaging was 54.5％,while it was 85.7％in the hysteroscopic tubal intubation.In those 89 patients with the intraoperative diagnosis,64 patients received the treatment with RF catheter expansion,totally 94 tubal expansion.The total patency rate was 79.8％,the postoperative follow-up rate 80.6％,and the live birth rate 45.6％.Conclusions:The hystero-laparoscopic surgery combined with RF catheter can be used in the treatment of tubal obstructive infertility due to its clearance of focus lesion,and the high postoperative tubal patency rate and pregnancy rate.