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目的探讨电视宫腹腔镜联合手术治疗输卵管性不孕症诊断和治疗价值。方法回顾分析2007年5月-2011年12月78例输卵管性不孕症患者采用宫腹腔镜联合治疗的临床资料。在腹腔镜下行盆腔粘连分离、输卵管整形、造口术、异位病灶电灼术等,利用宫腔镜直接观察宫腔内膜及输卵管开口,在直视下行输卵管插管。术后随访受孕情况。结果术中诊断输卵管周围炎33例;输卵管卵巢周围炎30例;输卵管积水15例;其中50例是由盆腔炎所致,28例由盆腔子宫内膜异位症所致。术后受孕率:输卵管和卵巢周围炎为42.9%(27/63);输卵管积水为20%(3/15)。结论宫腹腔镜联合手术治疗输卵管不孕症患者既能明确病因同时又能治疗,手术安全,输卵管复通率高,术后妊娠率明显改善。
Objective To discuss the value of laparoscopy combined with hysteroscope in the diagnosis and treatment of tubal infertility. Methods The clinical data of 78 cases of tubal infertility treated by hysteroscopy combined with laparoscopy from May 2007 to December 2011 were retrospectively analyzed. In laparoscopic pelvic adhesions separation, tubal plastic surgery, ostomy, ectopic lesions cauterization, the use of hysteroscopy direct observation of the endometrium and fallopian tube opening, fallopian tube intubation in direct vision. Postoperative follow-up of pregnancy. Results Intraoperative diagnosis of tubal inflammation in 33 cases; tubal ovarian inflammation in 30 cases; tubal hydronephrosis in 15 cases; of which 50 cases were caused by pelvic inflammatory disease, 28 cases caused by pelvic endometriosis. Postoperative pregnancy rates were 42.9% (27/63) for tubal and ovarian inflammation and 20% (3/15) for hydrosalpinx. Conclusions Hysteroscopy combined with surgical treatment of tubal infertility patients can not only clear the cause at the same time can be treated, surgical safety, high tubal recurrence rate, postoperative pregnancy rate was significantly improved.