CAJ | 학술논문

目的探讨介入性输卵管再通术联合腹腔镜治疗输卵管多发阻塞性不孕症的临床价值.方法回顾性分析67例127条输卵管近段阻塞合并同侧伞端粘连不孕患者资料,行选择性输卵管再通术后2～3 d利用腹腔镜对粘连伞端行分离及造口术.分析输卵管近三段再通率、完全再通率,随访1年观察妊娠率及相关并发症等.对术后1年未妊娠者行输卵管造影复查.结果 67例均成功实施输卵管再通术,近三段再通率为97.6%(124/127);联合腹腔镜对近三段再通的124条输卵管行伞端微创手术治疗,完全再通率为98.4%(122/124).术后1年妊娠率为58.2%(39/67),异位妊娠发生率为4.5%(3/67),未妊娠率为37.3%(25/67),其中输卵管再阻塞未妊娠率为25.4%(17/67),输卵管通畅未妊娠率为11.9%(8/67).结论介入性输卵管再通术联合腹腔镜是治疗输卵管多发阻塞性不孕症的有效方法,可有效提高妊娠率.
목적 탐토개입성수란관재통술연합복강경치료수란관다발조새성불잉증적림상개치.방법 회고성분석67례127조수란관근단조새합병동측산단점련불잉환자자료,행선택성수란관재통술후2～3 d이용복강경대점련산단행분리급조구술.분석수란관근삼단재통솔、완전재통솔,수방1년관찰임신솔급상관병발증등.대술후1년미임신자행수란관조영복사.결과 67례균성공실시수란관재통술,근삼단재통솔위97.6%(124/127);연합복강경대근삼단재통적124조수란관행산단미창수술치료,완전재통솔위98.4%(122/124).술후1년임신솔위58.2%(39/67),이위임신발생솔위4.5%(3/67),미임신솔위37.3%(25/67),기중수란관재조새미임신솔위25.4%(17/67),수란관통창미임신솔위11.9%(8/67).결론 개입성수란관재통술연합복강경시치료수란관다발조새성불잉증적유효방법,가유효제고임신솔.
Objective To explore the clinical value of therapeutic alliances of oviduct recanalization and video-laparoscope in the treatment of infertilitas feminis caused by multiple salpingemphraxis. Methods Sixty-seven patients with salpingemphraxis in 127 oviducts complicated with adhesions in fimbriated extremities were enrolled into our study. All the patients underwent separation of adherences in fimbriated extremities and neostomy using a video-laparoscope 2 to 3 days after selective oviduct recanalization. The therapeutic effects were retrospectively reviewed focusing on recanalization rate of proximal three segments, complete recanalization rate, and pregnancy rate and relevant complications during the follow-up period were analyzed. And patients with infertilitas feminis in the follow-up period underwent repeated salpingography to determine whether oviduct was repeatedly obstructed. Results The therapeutic alliance of oviduct recanalization and video-laparoscope were performed successfully in this cohort. Owing to the treatment of oviduct recanalization, recanalization rate of proximal three segments was 97.6% oviducts (124/127). Due to the alliance of oviduct recanalization and video-laparoscope, complete rate of oviduct were 98.4% (122/124). One year after operation, the pregnancy rate, ectopic pregnancy rate, and non pregnancy rate were 58.2% (39/67), 4.5% (3/67), and 37.3% (25/67), respectively. The patients with non pregnancy were composed by repeated oviduct obstruction in 25.4% (17/67) and non obstruction in 11.9% (8/67). Conclusion Therapeutic alliances of oviduct recanalization and video-laparoscope could be an effective method for the treatment of infertilitas feminis caused by multiple salpingemphraxis, and be helpful for the enhancement of pregnancy rate.