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目的:探讨不孕症患者合并输卵管积水的临床特点和妊娠结局。方法:回顾性分析149例输卵管积水不孕症患者(积水组)和532例单纯输卵管阻塞不孕症患者(单纯阻塞组)的临床资料。结果:经标准输卵管通液术后,积水组累积自然受孕率、宫内妊娠率、自然流产率和异位妊娠率分别为24.8%、86.5%、13.5%和0%,平均获孕时间为治疗后4.5±4.2个月;单纯阻塞组累积自然受孕率、宫内妊娠率、自然流产率和异位妊娠率分别为24.1%、85.9%、9.4%和7.0%,平均获得妊娠时间为治疗后4.6±3.7个月;组间各项指标均无统计学差异(P>0.05)。91.9%的患者输卵管积水≤3 cm,积水>3 cm的患者仅有1例自然受孕;单侧输卵管积水的患者占90.6%,双侧输卵管积水患者无1例自然受孕。结论:与单纯输卵管阻塞的不孕症患者相比,输卵管积水患者经治疗后也能获得较为理想的妊娠结局。不孕妇女输卵管积水具有以下特点:以≤3 cm和单侧积水为主,当积水>3 cm或出现双侧积水时,患者基本不能自然受孕。
Objective: To investigate the clinical features and pregnancy outcome of infertility patients with tubal hydrops. Methods: The clinical data of 149 patients with hydronephrosis (hydrocephalus group) and 532 patients with simple tubal obstruction infertility group (simple obstruction group) were retrospectively analyzed. Results: The cumulative rate of spontaneous conception, intrauterine pregnancy, spontaneous abortion and ectopic pregnancy were 24.8%, 86.5%, 13.5% and 0%, respectively. The average pregnancy time was 4.5 ± 4.2 months after treatment. The cumulative spontaneous conception rate, intrauterine pregnancy rate, spontaneous abortion rate and ectopic pregnancy rate in obstruction group were 24.1%, 85.9%, 9.4% and 7.0% respectively. The mean pregnancy time was 4.6 ± 3.7 months. There was no significant difference between the groups (P> 0.05). In 91.9% of the patients, only 1 case of hydrosalpinx ≤3 cm and hydrocephalus> 3 cm had spontaneous conception, 90.6% of patients with unilateral hydronephrosis, and 1 case of spontaneous conception of bilateral hydrosalpinx. Conclusion: Compared with infertility patients with simple tubal obstruction, tubal hydronephrosis patients can get better pregnancy outcomes after treatment. Infertility women have the following characteristics of hydrosalpinx: ≤3 cm and unilateral hydrocephalus, when the water> 3 cm or bilateral water, the patient can not naturally conceive.