宫腹腔镜在不孕症方面的临床应用

发布时间：2018-05-07 08:10

本文选题：不孕症 + 宫腔镜　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：探讨宫腔镜联合腹腔镜在不孕症方面的临床应用情况。方法：在从2009年3月至2012年3月来我院(大连医科大学附属2院）就诊行宫腹腔镜联合检查的不孕患者中随机选取80例，根据检查和诊断的情况采用相应的手术方法进行治疗，对所有患者的临床资料进行回顾分析。结果：1、80例不孕患者中原发性不孕31例（38.75%），继发性不孕49例（61.25%）；宫腹腔镜联合检查诊断结果与应用传统的HSG检查法检查出的结果相比，其差异明显，具有统计学意义。 2、经宫腹腔镜联合治疗后，80例患者中，治疗前有100条输卵管堵塞，60条通畅；治疗后12条堵塞，，148条通畅，输卵管疏通率达92.5%，与术前相比差异显著。 3、不孕患者的HSG与腹腔镜下通液结果进行比较，以后者作为标准，结果显示HSG诊断的假阳性率为19.42%，假阴性率48.42%，特异度80.58%，灵敏度51.58%，正确指数为67.84%。 4、术后对80例患者进行随访，1年内有33例受孕（其中32例为宫内孕，1例为宫外孕），妊娠率达41.25%；1~2年内有17例受孕（其中16例为宫内孕，1例为宫外孕），妊娠率达21.55%。结论：在临床诊断和治疗不孕症的过程中，将宫腔镜与腹腔镜联合应用是一种十分可行并且有效的方法，宫腹腔镜的联合应用将二者各自的优点结合起来，达到了协同作用，使这种方法具有创伤小、恢复快、术后并发症少、患者负担减轻等优点，在检查和诊断不孕症以及改善不孕患者的妊娠情况方面具有重要意义，临床应用前景很好。
[Abstract]:Objective: to investigate the clinical application of hysteroscopy combined with laparoscopy in infertility. Methods: from March 2009 to March 2012, 80 infertile patients who were admitted to our hospital (second affiliated Hospital of Dalian Medical University) for combined hysteroscopy and laparoscopy were randomly selected and treated by corresponding surgical methods according to the examination and diagnosis. The clinical data of all patients were analyzed retrospectively. Results among 80 infertile patients, 31 had primary infertility and 49 had secondary infertility. The results of combined hysteroscopy and laparoscopy were significantly different from those of traditional HSG. (2) in 80 patients with hysteroscopy combined with laparoscopy, there were 100 tubal blockages (60 patency) before treatment and 148 tubal blockages (148 patency) after treatment, and the fallopian tube dredging rate was 92.5% (P < 0.05), which was significantly different from that before treatment. 3. The results of HSG in infertile patients were compared with those of laparoscopy. The results showed that the false positive rate of diagnosis of HSG was 19.42, the false negative rate was 48.42, the specificity was 80.58, the sensitivity was 51.58, and the correct index was 67.84. (4) 80 cases were followed up after operation, 33 cases (including 32 cases of intrauterine pregnancy, 1 case of ectopic pregnancy), 17 cases (16 cases of intrauterine pregnancy, 1 case of ectopic pregnancy and 21.55%) were pregnant within 1 ~ 2 years after operation. Conclusion: in the process of clinical diagnosis and treatment of infertility, the combination of hysteroscopy and laparoscopy is a very feasible and effective method. The combination of hysteroscopy and laparoscopy can combine their respective advantages and achieve a synergistic effect. This method has the advantages of less trauma, faster recovery, less postoperative complications and less burden on patients. It is of great significance in the examination and diagnosis of infertility and the improvement of pregnancy status of infertile patients. The clinical application prospect is very good.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.6

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