腹腔镜下输卵管盆腔病变分期对不孕症预后的影响分析

目的：探讨腹腔镜下输卵管盆腔病变分期对不孕症患者预后的影响。方法：回顾分析2009年4月至2010年8月为80例输卵管远端梗阻性不孕患者行腹腔镜再通术的临床资料，并总结术后随访情况。结果：80例患者术后宫内总妊娠率为27．50％（22／80）。输卵管盆腔病变分为Ⅰ、Ⅱ、Ⅲ、Ⅳ期，术后1年宫内妊娠率分别为61．11％、38．10％、11．54％及O：输卵管病变Ⅰ-Ⅱ期的患者，术后宫内妊娠率明显高于Ⅲ-Ⅳ期的患者。结论：对于输卵管远端梗阻性不孕症的患者，腹腔镜是首选检查方式。腹腔镜手术可准确评估输卵管病变情况及盆腔粘连程度，并同时予以相应治疗。术后可根据术中输卵管盆腔病变分期情况指导患者选择助孕方式。

Analysis on the effect of laparoscopic staging of tubal and pelvic lesion on prognosis of patients with infertility

Objective： To explore the effect of laparoscopic staging of tubal and pelvic lesion on prognosis of patients with infer- tility. Methods ： Eighty patients with infertility caused by distal tubal obstruction underwent laparoscopic surgery from Apr. 2009 to Aug. 2010, their clinical data and postoperative follow-up data of 12 to 24 months were retrospectively reviewed. Results：The total postopera- tive pregnancy rate of 27.50% was found in eighty cases. According to the staging of tubal and pelvic lesion, the patients were classified as stage Ⅰ , Ⅱ , Ⅲ and Ⅳ ,61.11% ,38.10%, 11.54% and 0 of postoperative one year pregnancy rates were found respectively. The postoperative pregnancy rate of stage Ⅰ -Ⅱwas apparently higher than the stage Ⅲ-Ⅳ. Conclusions：For the patients with infertility caused by distal tubal obstruction, laparoscopy is the first choice for examination,the laparoscopic staging of tubal and pelvic lesion can accurately estimate the degree of tubal damage and the adhesion of pelvic cavity, and treat the diseases at the same time. Surgeons can provide patients appropriate method for pregnancy according to the staging of tubal and pelvic lesion.