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目的探讨宫腹腔镜联合治疗不孕症的临床价值,为临床治疗提供依据。方法回顾性分析2010年12月至2012年7月因不孕症接受宫腹腔镜联合手术诊治的患者43例,分析其不孕症的病因,观察术后患者输卵管通畅情况和妊娠率。结果经宫腹腔镜检查及病理诊断,43例不孕症患者中慢性盆腔炎21例(48.84%),子宫内膜异位症7例(16.28%),多囊卵巢4例(9.30%),子宫肌瘤5例(11.63%),宫腔粘连2例(4.65%),盆腔结核1例(2.33%),子宫畸形2例(4.65%),正常盆腔1例(2.33%)。引起女性不孕症的主要病因是慢性盆腔炎与盆腔粘连,多导致继发性不孕。子宫内膜异位症、多囊卵巢综合征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79.07%,术后输卵管通畅率为88.37%。43例术后随访1~24个月,随访率为100%。术后妊娠20例,妊娠率为46.51%,异位妊娠2例(4.65%),自然流产1例(2.33%)。结论不孕症病因复杂,选择个性化方案是治疗的关键。宫腹腔镜联合检查与治疗可作为不孕症治疗的首选方法。
Objective To investigate the clinical value of laparoscopy combined with laparoscopy in the treatment of infertility and provide the basis for clinical treatment. Methods Retrospective analysis of December 2010 to July 2012 due to infertility received laparoscopic hysteroscopic surgery in patients with 43 cases, analysis of the cause of infertility, tubal patency and postoperative pregnancy and pregnancy rates were observed. Results In the 43 cases of infertility, 21 cases (48.84%) had chronic pelvic inflammatory disease, 7 cases (16.28%) had endometriosis, 4 cases (9.30%) had polycystic ovary, Uterine fibroids in 5 cases (11.63%), uterine adhesions in 2 cases (4.65%), pelvic tuberculosis in 1 case (2.33%), uterine malformations in 2 cases (4.65%), normal pelvic in 1 case (2.33%). Cause female infertility is the main cause of chronic pelvic inflammatory disease and pelvic adhesions, and more lead to secondary infertility. Endometriosis, polycystic ovary syndrome is an important cause of female infertility, mainly caused by primary infertility. The preoperative tubal patency rate was 79.07%, postoperative tubal patency rate was 88.37%. 43 cases were followed up for 1 to 24 months, the follow-up rate was 100%. Postoperative pregnancy in 20 cases, the pregnancy rate was 46.51%, ectopic pregnancy in 2 cases (4.65%), spontaneous abortion in 1 case (2.33%). Conclusion The cause of infertility is complex, and the choice of individualized scheme is the key to treatment. Palace laparoscopic joint examination and treatment of infertility can be used as the preferred method of treatment.