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目的探讨宫腹腔镜联合手术对输卵管积水不孕症患者生育功能的改善情况。方法收集2008年7月至2010年6月接受宫腹腔镜联合手术的82例输卵管性不孕症患者的临床资料,剔除了3例因双侧输卵管近段梗阻建议行体外受精-胚胎移植(IVF-ET)后,最后共79例入组本研究。根据输卵管积水与否分为:输卵管积水组(42例)和非积水组(37例),随访2年,比较两组妊娠结局。结果总的宫内妊娠率为41.8%,其中积水组为31.0%(13/42),非积水组为54.1%(20/37),两组比较差异有统计学意义(P<0.05);积水组异位妊娠5例,流产3例,非积水组异位妊娠1例,流产1例,差异无统计学意义(P>0.05)。且妊娠率随积水程度加重而下降。结论输卵管积水影响不孕症患者宫腹腔镜术后生育结局,Ⅲ～Ⅳ期患者妊娠率明显降低,宫腹腔镜联合手术对其生育能力的改善有限。
Objective To investigate the effect of laparoscopic combined laparoscopy on fertility in patients with hydronephrosis of the oviduct. Methods The clinical data of 82 patients with tubal infertility who underwent laparoscopic hysteroscopic laparoscopy from July 2008 to June 2010 were collected. Three patients with IVF due to bilateral proximal tubal obstruction were excluded. -ET), a total of 79 cases were enrolled in this study. According to whether tubal hydrosalpinia or not: tubal hydrops group (42 cases) and non-hydronephrotic group (37 cases), followed up for 2 years, compared the two groups of pregnancy outcomes. Results The total intrauterine pregnancy rate was 41.8%, of which 31.0% (13/42) in hydronephrosis group and 54.1% (20/37) in non-hydronephrosis group, the difference was statistically significant (P 0.05) There were 5 cases of ectopic pregnancy in water group, 3 cases of abortion, 1 case of ectopic pregnancy in non-hydronephrosis group and 1 case of miscarriage, the difference was not statistically significant (P> 0.05). And the pregnancy rate decreased with the degree of hydrops. Conclusions Hydrosalpinx affects the reproductive outcomes after laparoscopic hysteroscopic surgery in infertility patients. The pregnancy rates in patients with stage Ⅲ ~ Ⅳ are significantly lower, and laparoscopic hysteroscopy combined with surgery has limited improvement in fertility.