【摘要】 目的  分析宮腔鏡聯合腹腔鏡在不孕癥診治中的應用和意義。 方法  回顧性分析2007年1月-2009年12月采用宮腔鏡聯合腹腔鏡手術診治92例女性不孕癥患者的臨床資料。 結果  92例中原發不孕39例，繼發不孕53例；其中有盆腔病變者86例，占93.5%。不孕原因居前四位分別是盆腔粘連31例（33.7%），輸卵管阻塞24例（26.1%），子宮內膜異位癥10例（10.9%），子宮內膜息肉8例（8.7%）。輸卵管阻塞24例行宮腔鏡引導下單極電凝器鈍性逆行分離術或造口術，有20例輸卵管復通，復通率66.7%。術后6~12個月年隨訪，妊娠率為19.6%（18/92），其中宮內妊娠15例，宮外孕3例。 結論  腹腔鏡聯合宮腔鏡檢查能快速準確地明確女性不孕的確切原因及部位，并可采取針對性治療措施，是目前診治不孕癥的可靠方法。
【Abstract】 Objective  To investigate the application and role of laparoscopy combined with hysteroscopy in the diagnosis and treatment of infertile patients. Methods  Ninety-two patient with infertility who examined and treated with laparoscopy combined with hysteroscopy in this hospital were retrospectively analyzed from January 2007 to December 2009. Results  There were 39 patients with primary infertility and 53 patients with secondary infertility.The main reason of infertility was pelvic diseases (93.5%). In the pelvic diseases,the common causes included pelvic adhesion (31 cases, 33.7%), obstruction of oviduct (24 cases, 26.1%), endometriosis (10 cases, 10.9%), and endometrial polyp (8 cases, 8.7%). Twenty-four patients with obstruction of oviduct were treated with hysteroscopy conducting unipolar electrocoagulation tool, 20 fallopian tubes were unobstructed. The recover rate was 66.7%. All the patients received follow-up by 6 - 12 months, and the pregnancy rate was 19.6% (18/92). Out of these 18 patients, 15 patients were intrauterine and 3 extrauterine. Conclusion  Laparoscopy combined with hysteroscopy can find out the exact reasons of infertility and offer the respective treatment, and be a reliable method to diagnose and treat infertility patient.

Citation： LIAO Xiaoyan. Clinical Analysis of Diagnosis and Treatment of Infertile Patients by Laparoscopy and Hysteroscopy. West China Medical Journal, 2010, 25(7): 1317-1319. doi: Copy

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