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有盆腔积液的通畅输卵管原发性不孕患者早期腹腔镜检查的价值。

Value of Early Laparoscopic Exploration for Primary Infertile Patients with Patent Fallopian Tubes Complicated with Pelvic Effusion.

机构信息

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China (mainland).

West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China (mainland).

出版信息

Med Sci Monit. 2022 Dec 15;28:e938637. doi: 10.12659/MSM.938637.

Abstract

BACKGROUND Endometriosis is a progressive disease, and early detection and early treatment are particularly important. The purpose of this study was to investigate the effect of the timing of laparoscopy on the spontaneous pregnancy rate of primary infertile patients complicated with pelvic effusion within 6 months after surgery. MATERIAL AND METHODS We enrolled 330 primary infertile patients with pelvic effusion and bilateral patent fallopian tubes. They were divided into 3 groups based on retrospective analysis of clinical data. Study Group 1 underwent laparoscopy 1 month after hysterosalpingography (HSG), Study Group 2 received laparoscopy after trying to conceive for 3 months, and the Control Group did not undergo laparoscopy. According to the specific conditions during laparoscopy, repair and plastic surgery of fallopian tube, electrocautery of endometriosis and uterine suspension were performed. The main observation indicators were proportions of retrograde menstruation, peritoneal endometriosis, and tubal adhesions in laparoscopy groups, and spontaneous pregnancy rates within 6 months. RESULTS The proportions of retrograde menstruation were 92.2% and 93.1% in Study Group 1 and Study Group 2, respectively, with no statistical significance. The proportions of peritoneal endometriosis were 51.0% and 64.7%, with a statistically significant difference. The proportions of tubal adhesions were 31.4% and 36.2%, with no statistical significance. The pregnancy rates within 6 months were 73.9%, 52.6%, and 13.1%, with a statistically significant difference for pairwise comparisons. CONCLUSIONS The pregnancy rate of primary infertile patients with patent fallopian tubes complicated with pelvic effusion can be significantly improved through early laparoscopic surgery (exploration and treatment).

摘要

背景

子宫内膜异位症是一种进行性疾病,早期发现和早期治疗尤为重要。本研究旨在探讨腹腔镜检查时机对术后 6 个月内合并盆腔积液的原发性不孕患者自然妊娠率的影响。

材料和方法

我们纳入了 330 例合并双侧输卵管通畅的盆腔积液原发性不孕患者。根据临床资料回顾性分析,将其分为 3 组。研究组 1 于子宫输卵管造影(HSG)后 1 个月行腹腔镜检查,研究组 2 在尝试受孕 3 个月后行腹腔镜检查,对照组未行腹腔镜检查。根据腹腔镜检查的具体情况,对输卵管进行修复和整形手术、子宫内膜异位症电灼和子宫悬吊。主要观察指标为腹腔镜组中逆行性月经、腹膜内异症和输卵管粘连的比例,以及 6 个月内的自然妊娠率。

结果

研究组 1 和研究组 2 的逆行性月经比例分别为 92.2%和 93.1%,差异无统计学意义。腹膜内异症的比例分别为 51.0%和 64.7%,差异有统计学意义。输卵管粘连的比例分别为 31.4%和 36.2%,差异无统计学意义。6 个月内的妊娠率分别为 73.9%、52.6%和 13.1%,两两比较差异有统计学意义。

结论

对于合并盆腔积液的输卵管通畅的原发性不孕患者,早期腹腔镜手术(探查和治疗)可显著提高妊娠率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566e/9764669/871e982c7ba7/medscimonit-28-e938637-g001.jpg

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