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目的:评价经阴道注水腹腔镜术和标准腹腔镜术在不孕症中的临床应用价值。方法:选取2009年2月～2011年2月就诊的100例不孕症患者为研究对象,先进行经阴道注水腹腔镜-宫腔镜联合检查,术后1～3天内,再对以上检查过的患者,进行标准经腹腹腔镜检查,观察两种检查方法中,输卵管通畅性及盆腔内其他病变情况的符合率、术中及术后并发症情况。结果:观察组经阴道注水腹腔镜-宫腔镜检查全部穿整成功,术中发现,双侧输卵管完全通畅54例,单侧或双侧输卵管不通共46例,合并盆腔粘连10例、子宫肌瘤2例,图像清晰,所有患者观察2小时后均安全离院。经标准经腹腹腔镜检查后发现,双侧输卵管完全通畅55例,单侧或双侧输卵管不通共45例;同时有合并有盆腔粘连8例、子宫肌瘤1例;两种检查中,均无一例发生直肠损伤、术中术后大出血等并发症。对患者输卵管通畅性及盆腔其他病变的临床效果无统计学意义(P>0.05)。结论:经阴道注水腹腔镜-宫腔镜检查,是一种更加快速、准确、微创、安全的检查方法,可作为女性不孕症患者的早期检查方法,对有输卵管阻塞或盆腔其他病变或检查不满意,需要进一步检查或治疗者,再进行标准腹腔镜手术。
Objective: To evaluate the clinical value of transvaginal laparoscopy and standard laparoscopy in infertility. Methods: From January 2009 to February 2011, 100 cases of infertility patients were selected as the research object, the first transvaginal laparoscopic-hysteroscopy joint examination, after 1 to 3 days, then the above examination Of patients, the standard laparoscopic abdominal examination to observe the two inspection methods, tubal patency and other pelvic lesions in line with the rate of intraoperative and postoperative complications. Results: In the observation group, transvaginal water laparoscopy - hysteroscopy was all successful in dressing. In the operation, 54 cases were found with bilateral tubal patency, 46 cases with unilateral or bilateral fallopian tube obstruction, 10 cases with pelvic adhesion, 2 cases of tumor, the image is clear, all patients were safe to leave after 2 hours observation. The standard abdominal laparoscopic examination found that the bilateral tubal completely patency in 55 cases, unilateral or bilateral fallopian tube does not pass a total of 45 cases; at the same time with pelvic adhesions in 8 cases, 1 case of uterine fibroids; both checks were No case of rectal injury, intraoperative and postoperative bleeding and other complications. There was no significant difference in the clinical efficacy of tubal patency and other pelvic lesions (P> 0.05). Conclusion: Transvaginal water injection laparoscopy - hysteroscopy, is a more rapid, accurate, minimally invasive, safe inspection method can be used as an early examination of female infertility patients with tubal obstruction or other pelvic lesions or Inspection is not satisfied, need further examination or treatment, and then standard laparoscopic surgery.