刘莉娜,
王化丽^,,
孙林,
姜盟,
哈斯夫
大连市妇幼保健院 生殖健康中心, 辽宁 大连 116021

详细信息 作者简介: 刘莉娜(1985-), 女, 主治医师。E-mail:tina1985927@163.com





通讯作者: 王化丽, 主任医师。E-mail:whl-dl@163.com 中图分类号: R711.6


摘要:目的探讨宫腔镜联合腹腔镜下输卵管修复整形术治疗输卵管性不孕（tubal factor infertility，TFI）的疗效。方法对213例行宫腔镜联合腹腔镜下输卵管修复整形手术治疗的患者进行输卵管评分分期，其中Ⅰ期35例，Ⅱ期78例，Ⅲ期64例，Ⅳ期36例。观察TFI患者术后感染情况，平均住院时间，并比较输卵管复通率及妊娠结局。结果不同分期的患者术后感染情况两两比较，差异有统计学意义（P < 0.05）；各期患者术后住院时间差异无统计学意义（P>0.05）。各期术后输卵管评分均明显低于术前，差异有统计学意义（P < 0.001）。术后不同分期的输卵管评分比较，差异有统计学意义，且经两两多重比较，分期越高，术后输卵管评分越高，各期间差异均有统计学意义（P < 0.001）。各期患者术后输卵管复通情况比较，分期越高，术后复通率越差，差异有统计学意义（P < 0.001）。各期患者妊娠率比较，分期越高，术后妊娠率越低，各期患者两两比较，差异有统计学意义，P均 < 0.001。结论TFI患者通过宫腔镜联合腹腔镜手术治疗，可明显提高患者的输卵管复通率，增加患者自然妊娠率。
关键词: 宫腔镜联合腹腔镜/
输卵管修复整形术/
输卵管性不孕


Abstract:ObjectiveTo investigate the effect of hysteroscopy combined with laparoscopic fallopian tube repair and plastic surgery in the treatment of tubal factor infertility (TFI).MethodsTube score staging was performed on 213 patients who underwent hysteroscopy combined laparoscopic fallopian tube repair and plastic surgery, including Ⅰ stage 35 cases, Ⅱ stage 78 cases, Ⅲ stage 64 cases, and Ⅳ stage 36 cases. The postoperative infection of TFI patients was observed. The average length of hospital stay, the rate of fallopian tube recanalization and pregnancy outcome were compared.ResultsPairwise comparison of postoperative infection in patients with different stages showed statistically significant differences (P < 0.001). There was no statistically significant difference in postoperative hospital stay among the patients (P>0.05). The score of fallopian tube after operation in each stage was significantly lower than that before operation, and the difference was statistically significant (P < 0.001). Comparison of postoperative tubal scores of different stages showed statistically significant differences. Moreover, after multiple comparisons, the higher the stages were, the higher the postoperative tubal scores were, and the differences in each period were statistically significant (P < 0.001). The higher the stage was, the worse the postoperative tubal recanalization rate was, and the difference was statistically significant (P < 0.001). The higher the stage was, the lower the postoperative pregnancy rate was, and the difference was statistically significant (P < 0.001).ConclusionHysteroscopy combined with laparoscopic surgery can significantly improve the rate of fallopian tube recanalization and increase the rate of natural pregnancy in TFI patients.
Keywords:hysteroscopy combined with laparoscopy/
tubal repair and plastic surgery/
tubal infertility

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