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经阴道注水腹腔镜联合宫腔镜在不孕症诊治中的应用 被引量:5

Advantage of transvaginal hydrolaparoscopy combined with hysteroscopy on diagnosis and treatment of infertility
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摘要 目的探讨经阴道注水腹腔镜(THL)联合官腔镜检查在不孕症诊治中的应用价值。方法对400例术前子宫输卵管碘油造影(HSG)诊断至少有一条输卵管间质部阻塞的不孕症患者施行THL联合宫腔镜下输卵管插管术。观察THL穿刺成功率、输卵管通畅性的再评价、盆腔粘连诊断率,子宫内膜异位症(EM)诊断率、副输卵管诊断率和并发症发生率。结果 THL穿刺成功率为97.5%,对HSG诊断为间质部阻塞的输卵管联合术后再评价通畅的占86.0%,盆腔粘连诊断率为39.7%,EM诊断率为14.1%,副输卵管诊断率为5.4%,并发症发生率为1%,术后一年内的妊娠率为23.8%。结论 THL联合宫腔镜检查具有准确、微创、安全、经济等优点,可作为不孕症门诊诊治中的一线方法。 Objective: To evaluate the advantage 6f transvaginal hydrolaparoscopy (THL) combined with hysteroscopy on diagnosis and treatment of infertility. Methods. Four hundreds infertile women with at lest one side fallopian tube obstruction in interstitial position received THL combined with hysteroscopy and tubal catheterization. The patients included 203 primary and 197 secondary infertile patients. The success insertion rate, pelvic endometriosis rate, para- fallopian tube rate, complication rate, and postoperative pregnancy rate within one year after treatment were observed and the fallopian tube patency was re-evaluated. Results. The success insertion rate of THL was 97.5%, the rate of pelvic adhesion 39.7%, the pelvic endometriosis rate 14.1%, the diagnosis rate of para-fallopian tube 5.4% during THL, the complications rate 1%, and postoperative pregnancy rate in one year 23.8%. The 86.0% of obstructed fallopian tube became unobstructed, which was evaluated by hysterosalipingography. Conclusions: The transvaginal hydrolaparoscopy combined with hysteroscopy is minimally invasive, safe and economical. It could provide a first-line procedure for diagnosis and treatment of infertile patient.
出处 《生殖医学杂志》 CAS 2012年第4期350-353,共4页 Journal of Reproductive Medicine
基金 河北省人口与计划生育委员会项目(2009-B08)
关键词 经阴道注水腹腔镜 宫腔镜检查 输卵管插管 不育 Transvaginal hydrolaparoscopy Hysteroscopy Catheterization Infertility
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参考文献10

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二级参考文献1

共引文献8

同被引文献37

  • 1王海燕,乔杰,马彩虹,陈新娜,范燕宏,王丽娜,李蓉.腹腔镜下治疗输卵管粘连及远端梗阻的临床结局[J].中国微创外科杂志,2007,7(3):221-223. 被引量:36
  • 2徐虹,汪龙霞,罗渝昆,王军燕,高学文,姬红娟.子宫输卵管三维超声造影检查在不孕症诊断中的临床价值[J].中华医学超声杂志(电子版),2011,8(12):2578-2584. 被引量:24
  • 3Marana R,Ferrari S,Merola A,et al. Role of a mini-invasive approach in the diagnosis and treatment of tubo-peritoneal infertility as an alternative to IVF[J]. Minerva Ginecol, 2011 , 63 (1):1-10.
  • 4Torre A, Pouly JL, Wainer B. Anatomic evaluation of the female of the infertile couple[J]. J Gynecol Obstet Biol Reprod (Paris),2010, 39(8 Suppl 2) : S34-44.
  • 5Jonsdottir K, Lundorff P. Transvaginal hydrolaparoscopy: a new diagnostic tool in infertility investigation [J]. Acta Obstet Gynecol Scand,2002,81 (9) :882-885.
  • 6Sobek A Jr, Hammadeh M, Vodicka J, et al. Uhrasonographically guided transvaginal hydrolaparoscopy [J]. Acta Obstet Gynecol Scand, 2008,87(10) : 1077-1080.
  • 7Moore ML,Cohen M,Liu GY. Experience with 109 cases of transvaginal hydrolaparoscopy [J]. J Am Assoc Gynecol Laparosc, 2003,10(2) :282-285.
  • 8Shibahara H,Shimada K,Kikuehi K,et al. Major complications and outcome of diagnostic and operative transvaginal hydrola- paroscopy [J]. Obstet Gynaecol Res, 2007,33 (5) : 705 -709.
  • 9Marana R,Ferrari S,Merola A,et al.Role of a mini-invasive approachin the diagnosis and treatment of tubo-peritoneal infertility as analtenative to IVF.Minerva Ginecol,2011 ,63(1):1-10.
  • 10Jonsdottir K,Lundorff P.Transvaginal hydrolaparoscopy: a newdiagnostic tool in infertility investigatio.Acta Obstet Gynecol Scand,2002,81(9):882-885.

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