| 陈丽融,刘常燕,李 莹,王 茜,胡又丹.宫腹腔镜联合治疗输卵管阻塞性不孕症的疗效及在不同年龄及阻塞类型中疗效差异[J].,2017,17(32):6340-6344 |
| 宫腹腔镜联合治疗输卵管阻塞性不孕症的疗效及在不同年龄及阻塞类型中疗效差异 |
| Study on Efficacy of Hysteroscopy Combined with Laparoscopy on Salpingemphraxis Infertility |
| 投稿时间：2017-05-16 修订日期：2017-06-10 |
| DOI：10.13241/j.cnki.pmb.2017.32.031 |
| 中文关键词: 宫腔镜 腹腔镜 输卵管阻塞 不孕症 临床效果 |
| 英文关键词: Hysteroscope Laparoscope Salpingemphraxis Infertility Clinical efficacy |
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| 中文摘要: |
| 摘要 目的：探讨宫腹腔镜联合治疗输卵管阻塞性不孕症的临床治疗效果及在不同年龄及阻塞类型中的疗效差异。方法：选取2013年2月至2015年2月间我院收治的70例输卵管性不孕症患者，按照随机数字表法分为两组，对照组（n=35例）行宫腔镜引导下的输卵管疏通术，观察组（n=35例）在对照组治疗方案上联合腹腔镜治疗，比较两组的临床治疗效果，同时比较宫腹腔镜联合对不同年龄段以及不同阻塞类型患者的临床治疗效果。结果：观察组输卵管通畅情况优于对照组（Z= -2.207，P=0.027）；观察组输卵管再通率高于对照组[82.86% vs 60.00%]，差异有统计学意义（x2=4.480，P=0.034）。两组治疗后并发症发生率无差异（P>0.05）。观察组治疗后1年总妊娠率高于对照组[82.86% vs 57.14%]，差异有统计学意义（P<0.05）；宫内妊娠率高于对照组[80.00% vs 51.43%]，差异有统计学意义（P<0.05）。年龄≤30岁组与年龄＞30岁组患者输卵管再通率、总妊娠率、宫内妊娠率无差异（P>0.05）。壶腹部或伞部阻塞患者输卵管再通率、总妊娠率、宫内妊娠率均高于间质部阻塞患者和峡部阻塞患者，差异有统计学意义（P<0.05）。结论：宫腹腔镜联合治疗输卵管阻塞性不孕症具有较好的疗效，且输卵管再通率和妊娠率得到明显提高，术后并发症也较少，并且对输卵管壶腹部或伞部阻塞的术后再通率效果最好。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the efficacy of hysteroscope combined with laparoscope combined with in the treatment of salpingemphraxis infertility and differences in efficacy of different ages and types of obstruction. Methods: A total of 70 patients with salpingemphraxis infertility, who were admitted to Dazhou Integrated Traditional Chinese and Western Medicine Hospital of Sichuan Province from February 2013 to February 2015, were randomly divided into control group(n=35) and observation group (n=35). The control group (n=35) underwent dredge tubal operation guided by hysteroscope, while the observation group was received laparoscopic treatment on the treatment plan of the control group. The clinical effects of the two groups were compared, at the same time, the clinical effects of hysteroscopy combined with laparoscopy on different age groups and different types of obstruction were compared. Results: The patency of fallopian tube in the observation group was better than that in the control group (Z= -2.207, P=0.027). The fallopian tube recanalization rate in the observation group was higher than that in the control group [82.86%vs60.00%], the difference was statistically significant (x2=4.480, P=0.034). There was no difference in the incidence of complications after treatment between the two groups (P>0.05). The overall pregnancy rate in the observation group 1 year after treatment was higher than that in the control group [82.86%vs57.14%], the difference was statistically significant (P<0.05). The intrauterine pregnancy rate in the observation group was higher than that in the control group [80.00%vs51.43%], the difference was statistically significant (P<0.05). There were no statistical differences in tubal recanalization rate, overall pregnancy rate, intrauterine pregnancy rate of patients between ≤30 years and >30 years (P>0.05). The fallopian tube recanalization rate, total pregnancy rate and uterine pregnancy rate in the patients with ampulla or umbrella obstruction were higher than those in interstitial obstructive patients and isthmus obstructive patients,the difference was statistically significant (P<0.05). Conclusion: Hysteroscope combined with laparoscope in the treatment of salpingemphraxis infertility has better clinical efficacy, and the recanalization rate and pregnancy rate of fallopian tube are obviously improved,with less postoperative complications and the highest recanalization rate of fallopian tube, ampulla or umbrella block. |
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