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目的:探讨输卵管插管联合宫、腹腔镜诊治输卵管性不孕的手术方式及应用价值。方法:对2005年1月~2006年6月住该院的160例因输卵管原因引起的不孕症患者采用输卵管插管联合宫腔镜、腹腔镜进行检查、诊断,并视术中的不同情况进行不同的手术方式治疗,术后2年进行随访。结果:160例病人316根输卵管,发现输卵管病变316根,手术复通221根,复通率69.94%。壶腹部、伞部阻塞术后复通率(87.64%)明显高于间质部和峡部阻塞的术后复通率(25.0%、35.53%),差异有极显著意义(P<0.001)。术后2年随访到的139例患者,有55例妊娠,妊娠率为39.57%。结论:输卵管插管联合宫、腹腔镜能同时对输卵管病变者进行诊断与治疗,创伤小、恢复快,手术成功率高,术后妊娠率较满意,是输卵管性不孕病人的首选治疗方法。
Objective: To investigate the surgical methods and application value of tubal intubation combined with uterus and laparoscopy in diagnosis and treatment of tubal infertility. Methods: From January 2005 to June 2006, 160 inpatients with infertility who lived in the hospital from January 2005 to June 2006 were examined and diagnosed by tubal intubation combined with hysteroscopy and laparoscopy. According to the different conditions Different surgical treatment, follow-up after 2 years. Results: There were 316 tubal tubes in 160 patients and 316 tubal lesions were found. There were 221 root canal recurrences and the recurrence rate was 69.94%. The amputation rate of the ampulla and umbrella was 87.64%, which was significantly higher than those of the isthmus and isthmus (25.0%, 35.53%). The difference was significant (P <0.001). Of the 139 patients who were followed up 2 years after operation, 55 were pregnant and the pregnancy rate was 39.57%. Conclusions: The combination of tubal intubation and laparoscopy can diagnose and treat tubal lesions at the same time. It has less trauma, faster recovery, higher operation success rate and more satisfactory postoperative pregnancy rate. It is the first choice for treatment of tubal infertility.