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目的:探讨宫腹腔镜联合手术在诊治女性不孕症中的临床价值。方法:回顾性分析2004年1月～2010年1月因不孕症接受宫腹腔镜联合手术诊治的患者262例,镜下评估不孕症的病因,观察术后患者输卵管通畅情况和妊娠率。结果:262例不孕症患者中,盆腔病变107例,宫腔病变90例,同时存在盆腔和宫腔病变65例。慢性盆腔炎与盆腔粘连是引起女性不孕症的首位病因,主要引起继发不孕。子宫内膜异位症、多囊卵巢综合征也是引起女性不孕症的重要原因,主要引起原发不孕。术前输卵管通畅率为74.13%,术后输卵管通畅率为91.11%。术后随访1～24月,223例获随访,随访率为85.11%。术后妊娠135例,妊娠率为51.53%,异位妊娠14例(5.34%),流产10例(3.82%)。结论:宫腹腔镜联合手术在诊治女性不孕症方面能够优势互补,在诊断的同时给予治疗,漏检率低、创伤小、并发症少,对女性不孕症的诊治有重要的临床价值。
Objective: To investigate the clinical value of laparoscopic combined laparoscopy in the diagnosis and treatment of female infertility. Methods: A retrospective analysis of January 2004 to January 2010 due to infertility received laparoscopic hysteroscopic surgery in patients with 262 cases of microscopic evaluation of the cause of infertility, tubal patency and postoperative pregnancy and pregnancy rates were observed. Results: In 262 infertility patients, there were 107 cases of pelvic lesions and 90 cases of uterine cavity lesions, and there were 65 cases of pelvic and uterine lesions at the same time. Chronic pelvic inflammatory disease and pelvic adhesions are the leading cause of female infertility, mainly caused by secondary infertility. Endometriosis, polycystic ovary syndrome is also an important cause of female infertility, mainly caused by primary infertility. Preoperative tubal patency rate was 74.13%, postoperative tubal patency rate was 91.11%. One to 24 months follow-up, 223 cases were followed up, the follow-up rate was 85.11%. Postoperative pregnancy was performed in 135 cases, with a pregnancy rate of 51.53%, ectopic pregnancy in 14 cases (5.34%) and abortion in 10 cases (3.82%). Conclusion: Hysteroscopy combined with surgery in the diagnosis and treatment of female infertility can complement each other, while giving diagnosis and treatment, low detection rate, less trauma, fewer complications, diagnosis and treatment of female infertility have important clinical value.