腹腔镜联合宫腔镜诊治输卵管性不孕52例分析

目的探讨应用宫、腹腔镜对输卵管性不孕的诊断价值及治疗效果.方法对52例经子宫输卵管碘油造影(HSG)诊断为输卵管性不孕的患者,单用腹腔镜下子宫导管内加压注入美蓝液检查证实双侧输卵管通畅者8例,一侧通畅者4例,双侧因各不同部位梗阻而不通者40例.对双侧及一侧不通的44例患者,根据不同部位病变进行治疗,如盆腔粘连松解,伞端扩张、造口及宫腔镜下输卵管间质部插管加压通液,开腹显微外科输卵管吻合、宫角植入等.结果52例输卵管性不孕患者中,双侧榆卵管通畅40例(77%),单侧通畅10例(19%),完全不通2例(3.9%).结论应用宫、腹腔镜联合检查、治疗输卵管性不孕,可避免单独使用宫腔镜、腹腔镜或开腹整形的局限性,提高诊断的准确性及治疗效果.

Treament of Tubal Infertility by Combined Laparoscopy and Hysteroscopy

Objective:To investigate the diagnostic value and effectiveness of teatment with combined laparoscopy and nesteroscopy in patients with tubal infertility.Method:Fifty two cases were diagnosed by hysterosalpingography(HSG),among which 8 cases were confirmed bilateral unobstructed tubes laparoscopically,four cases with unilateral unobstructed tube,forty cases with bilateral obstructed tubes at different patrs.For these 40 patients with obstructed tubes unilaterally or bilaterally,treatment including laparoctomy,microsurgery,and treatment under hysteroscopy.Results:After treatment,40 out of the 52 patients(77%)had bilateral unobstructed tubes,10(19%)had unilateral tube,and only 2(3.9%)had complete bilateral obstructed tubes.Conclusion:Patients with tubal infertility can be diagnosed and treated with combination of laparoscopy and hysteroscopy to avoid the limitation using Only one proceure method and improve the accuracy of diagnose and effectiveness of the treatment.