宫腹腔镜联合辅助生殖技术治疗输卵管性不孕的临床疗效

目的：探讨宫腹腔镜联合辅助生殖技术治疗输卵管性不孕的效果。方法：2008年2月—2010年8月共146例输卵管性不孕患者接受宫腹腔镜联合治疗，术后电话随访妊娠情况。术后半年内未妊娠的112例患者中54例患者行体外受精-胚胎移植（IVF-ET）助孕，电话随访其妊娠情况。结果：146例患者中宫腹腔镜联合术后妊娠46例（妊娠率36.22%），包括宫内妊娠40例，异位妊娠6例。术后随访0~6个月内妊娠34例，其中宫内妊娠30例，异位妊娠4例；7～12个月内妊娠11例，其中宫内妊娠9例，异位妊娠2例；12个月后妊娠1例，为宫内妊娠。54例患者IVF-ET后妊娠23例，其中宫内妊娠21例，异位妊娠2例。42例输卵管积水患者中，妊娠8例，其中宫内妊娠7例，异位妊娠1例。结论：宫腹腔镜联合手术对输卵管性不孕有一定的诊疗价值，术后半年内妊娠率最高，半年之后妊娠率明显下降，术后半年内未妊娠或输卵管病变严重者建议尽早行IVF-ET助孕。

Efficacy of Laparoscopy and Hysteroscopy Combined with ART for the Treatment of Oviduct Obstructive Infertility

Objective：To evaluate the efficacy of the laparoscopy and hysteroscopy combined with assisted reproductive techniques on the treatment of oviduct obstructive infertility. Methods：146 patients with oviduct obstructive infertility treated with the laparoscopy combined with hysteroscopy from February 2008 to August 2010 were followed up for the pregnancy. There were 112 patients （112/146） without pregnancy after six months of operation. Fifty-four cases （54/112） did IVF-ET. The pregnancy rate was analyzed. Results：In 146 cases，46 cases were pregnant after the laparoscopy combined with hysteroscopy （40 cases palace pregnancy，6 cases ectopic pregnant）. Among them，34 cases were pregnant between 0 and 6 months after surgery （30 cases palace pregnancy， 4 cases ectopic pregnant），11 cases were pregnant between 7 and 12 months （9 cases palace pregnancy，2 cases ectopic pregnant），1 case was pregnant after 12 months. In 54 cases treated with IVF-ET，23 cases were pregnant after 7 months to 1 year （21 cases palace pregnancy，2 cases ectopic pregnant）. Conclusions：The laparoscopy combined with hysteroscopy have both diagnostic and therapeutic value. Within six months after surgery，the pregnancy rate was the highest. Those patients who were not pregnant after 6 months of operation or had severe oviduct obstruction should do IVF-ET as early as possible.