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诊断性宫腹腔镜检查在不孕症评估中的作用:一项对300例患者的回顾性研究。

Role of diagnostic hystero-laparoscopy in the evaluation of infertility: A retrospective study of 300 patients.

作者信息

Nayak Prasanta K, Mahapatra Purna C, Mallick Jj, Swain S, Mitra Subarna, Sahoo Jayaprakash

机构信息

Department of Obstetrics and Gynaecology, Sriram Chandra Bhanj Medical College, Odisha, India.

出版信息

J Hum Reprod Sci. 2013 Jan;6(1):32-4. doi: 10.4103/0974-1208.112378.

Abstract

OBJECTIVE

To determine the role of diagnostic hysterolaparoscopy in the evaluation of infertility in tertiary care centres.

MATERIALS AND METHODS

This retrospective study was conducted at two tertiary care centres (the infertility clinics of Sriram Chandra Bhanj Medical College and Prachi hospital at Cuttack, Odisha) throughout the year in 2008. Women aged 20-40 years with normal hormone profile without male factor infertility were included.

RESULTS

Out of 300 cases, 206 (69%) patients had primary infertility. While laparoscopy detected abnormalities in 34% of the cases, significant hysteroscopy findings were noted in 18% of cases. Together, diagnostic hysterolaparoscopy detected abnormalities in 26% of the infertile patients in both groups. While the most common laparoscopic abnormality was endometriosis (14%) and adnexal adhesion (12%) in primary and secondary infertile patients, respectively, hysteroscopy found intrauterine septum as the most common abnormality in both groups.

CONCLUSIONS

Hysterolaparoscopy is an effective diagnostic tool for evaluation of certain significant and correctable tubo-peritoneal and intrauterine pathologies like peritoneal endometriosis, adnexal adhesions, and subseptate uterus, which are usually missed by other imaging modalities.

摘要

目的

确定诊断性宫腔镜腹腔镜联合检查在三级医疗中心不孕症评估中的作用。

材料与方法

本回顾性研究于2008年全年在两家三级医疗中心(奥里萨邦科塔克市的斯里拉姆·钱德拉·班杰医学院不孕症诊所和普拉奇医院)开展。纳入年龄在20 - 40岁、激素水平正常且无男性因素不孕的女性。

结果

在300例病例中,206例(69%)患者为原发性不孕。腹腔镜检查在34%的病例中发现异常,宫腔镜检查在18%的病例中有显著发现。宫腔镜腹腔镜联合检查在两组不孕患者中均有26%检测到异常。原发性和继发性不孕患者中,腹腔镜检查最常见的异常分别是子宫内膜异位症(14%)和附件粘连(12%),而宫腔镜检查发现两组中最常见的异常均为子宫中隔。

结论

宫腔镜腹腔镜联合检查是评估某些重要且可纠正的输卵管 - 腹膜及子宫内病变(如腹膜子宫内膜异位症、附件粘连和不完全中隔子宫)的有效诊断工具,这些病变通常会被其他影像学检查遗漏。

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