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目的:探讨中药联合腹腔镜手术治疗慢性盆腔炎盆腔粘连所致不孕的效果及盆腔粘连程度等对术后妊娠率的影响。方法:收集经腹腔镜检查诊治的慢性盆腔炎盆腔粘连所致不孕的病例254例,随机分为两组:治疗1组采用中药配合腹腔镜手术治疗,治疗2组为单纯腹腔镜手术治疗,根据术中所见将盆腔粘连程度分为轻、中、重三度,随访治疗后妊娠情况并探讨手术效果的影响因素。结果:(1)在盆腔轻度及中度粘连者中,治疗1组治疗后妊娠率明显高于治疗2组。(2)在重度病变者中,两组治疗后妊娠率、流产率及校正妊娠率均无显著性差异。(3)盆腔轻度粘连者术后妊娠率明显高于中度病变者和重度病变者。(4)不孕时间在≤2年的患者术后妊娠率明显高于不孕时间在3年以上的患者。结论:对轻、中度慢性盆腔炎盆腔粘连所致不孕的治疗中药联合腹腔镜手术效果明显优于单纯腹腔镜手术,腹腔镜术后妊娠率受盆腔粘连程度及不孕时间等的影响。
Objective: To investigate the effect of traditional Chinese medicine combined with laparoscopic surgery on pelvic adhesions caused by chronic pelvic inflammatory disease and pelvic adhesions on the rate of postoperative pregnancy. Methods: A total of 254 cases of infertility due to pelvic adhesions caused by chronic pelvic inflammation diagnosed and treated by laparoscopy were randomly divided into two groups: one group treated by traditional Chinese medicine combined with laparoscopic surgery, the other two group treated by simple laparoscopic surgery, According to intraoperative findings pelvic adhesions into mild, moderate and severe degree, follow-up after treatment of pregnancy and explore the impact of surgical effects. Results: (1) In mild and moderate pelvic adhesions, the pregnancy rate in treatment group 1 was significantly higher than that in treatment group 2. (2) There was no significant difference in the pregnancy rate, miscarriage rate and corrected pregnancy rate between the two groups after severe treatment. (3) Postoperative pelvic mild adhesion was significantly higher than those with moderate and severe lesions. (4) The pregnancy rate of patients with infertility ≤2 years was significantly higher than that of patients with infertility ≥3 years. Conclusion: The treatment of pelvic adhesions caused by mild to moderate chronic pelvic adhesions is more effective than simple laparoscopic surgery in the treatment of infertility caused by pelvic adhesions. The pregnancy rate after laparoscopic surgery is affected by pelvic adhesions and infertility time.