腹腔镜下宫腔镜输卵管插管术治疗近端输卵管梗阻。
Hysteroscopic tubal catheterization under laparoscopy for proximal tubal obstruction.
机构信息
Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
出版信息
Arch Gynecol Obstet. 2011 Dec;284(6):1573-6. doi: 10.1007/s00404-011-2007-6. Epub 2011 Jul 21.
PURPOSE
The purpose of this study was to investigate the fertility outcomes of infertile patients having proximal tubal obstruction treated with hysteroscopic tubal catheterization (HCT) for recanalization under diagnostic laparoscopy.
METHODS
From January 2000 to December 2008, diagnostic laparoscopy was used to assess the tubal status of 61 patients with unilateral or bilateral proximal tubal obstruction, as confirmed by hysterosalpingography. Among them, 35 patients with tubal obstruction confirmed by chromopertubation under laparoscopy subsequently underwent HCT. The pregnancy outcomes and success rates of recanalization were investigated.
RESULTS
In the 35 patients with confirmed tubal obstruction, HCT was performed in 54 fallopian tubes. The success rate of recanalization was 25.9% (14/54) per tube and 37.1% (13/35) per patient. Of the patients in whom tubal patency was restored, 4 achieved pregnancy, including 1 tubal pregnancy and 1 miscarriage. Among the 61 patients, excluding 14 who underwent in vitro fertilization-embryo transfer (IVF-ET) after laparoscopy, 13 were pregnant (27.7%), 9 gave live births, 1 had tubal pregnancy, and 3 had miscarriages.
CONCLUSIONS
HCT under laparoscopy is an option for couples with tubal infertility who do not prefer IVF-ET.
目的
本研究旨在探讨在诊断性腹腔镜下对近端输卵管阻塞的不孕患者行宫腔镜输卵管插管（HCT）再通术的生育结局。
方法
2000 年 1 月至 2008 年 12 月，对 61 例单侧或双侧近端输卵管阻塞的患者（经子宫输卵管造影证实）行诊断性腹腔镜检查，评估输卵管状况。其中 35 例腹腔镜下输卵管插管通畅性检查证实为输卵管阻塞的患者随后行 HCT。对妊娠结局和再通成功率进行了研究。
结果
在 35 例证实为输卵管阻塞的患者中，对 54 条输卵管行 HCT。每条输卵管的再通成功率为 25.9%（14/54），每位患者的再通成功率为 37.1%（13/35）。在输卵管通畅的患者中，有 4 例成功妊娠，包括 1 例输卵管妊娠和 1 例流产。在 61 例患者中，排除 14 例腹腔镜检查后行体外受精-胚胎移植（IVF-ET）的患者，13 例妊娠（27.7%），9 例活产，1 例输卵管妊娠，3 例流产。
结论
对于不倾向于 IVF-ET 的输卵管性不孕患者，腹腔镜下 HCT 是一种选择。
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